NPIMap

Gayle Witham

Organization Active NPI Clinical Social Worker · Grand Rapids, MI

NPI 1255780979 · NPPES record last updated Jun 3, 2016

Key facts

NPI
1255780979
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Social Worker 1041C0700X
License
6801085993 (MI)
Legal business name
GAYLE WITHAM
Practice address
558 Winona Ave NW
Grand Rapids, MI 49504-4740
Phone
(616) 477-3404
NPI assigned
Jun 3, 2016
Organization subpart
No

Authorized official

Name
Gayle Witham, LMSW, ACM NPI 1104330307
Title
Social Work
Phone
(616) 477-3404

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Corporate family (same tax ID) 13

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Community Care Services (456 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker
Group: 193400000X SINGLE SPECIALTY GROUP		 1041C0700X 6801085993 MI Yes

Addresses

Primary practice location

558 Winona Ave NW
Grand Rapids, MI 49504-4740

Mailing address

558 Winona Ave NW
Grand Rapids, MI 49504-4740
Phone (616) 477-3404

Other providers in Grand Rapids, MI

All providers in Grand Rapids, MI · Clinical Social Worker in Michigan

Sources for this page

Verify at the official NPI Registry.