NPIMap

Organization Active NPI

Gayle Witham

  • Clinical Social Worker
  • Grand Rapids, MI
National Provider Identifier
1255780979
Registry record updated Jun 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801085993 Issued in 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
Last updated
Jun 3, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

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

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X 6801085993 MI Primary

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

National Provider Directory

National Provider Directory
Tax ID family
Az Trans456 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 13

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 13

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464912000000",
    "number": "1255780979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "558 WINONA AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495044740",
            "telephone_number": "616-477-3404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 WINONA AVE NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495044740",
            "telephone_number": "616-477-3404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAYLE WITHAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-03",
        "last_updated": "2016-06-03",
        "status": "A",
        "authorized_official_last_name": "WITHAM",
        "authorized_official_first_name": "GAYLE",
        "authorized_official_title_or_position": "SOCIAL WORK",
        "authorized_official_telephone_number": "616-477-3404",
        "authorized_official_credential": "LMSW, ACM"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801085993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.