Individual provider Active NPI

Gerald Wista MC Gee II, LISW-S

  • Clinical Social Worker
  • Euclid, OH
National Provider Identifier
1275779126
Registry record updated Oct 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I0800373 Issued in OH
Practice address
26300 Euclid Ave Ste 534
Euclid, OH 44132-3708
Phone
(216) 647-1411
Fax
(216) 273-7887
NPI assigned
Dec 24, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I0800373 OH Primary

Addresses

Primary practice location

26300 Euclid Ave Ste 534
Euclid, OH 44132-3708

Mailing address

26300 Euclid Ave Ste 534
Euclid, OH 44132-3708
Phone (216) 647-1411

Other practice location 1

291 E 222nd St Rm 205
Euclid, OH 44123-1718
Phone (216) 647-1411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

26300 Euclid Ave
Suite 534
Euclid, OH 44132-3708

3460 S Dixie Dr
Dayton, OH 45439-2321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I0800373OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Everyday People Individual and Family Counseling Center CurrentSince Oct 9, 2022 Accepting new patients

Locations

291 E 222nd St
Ste 207
Euclid, OH 44123

291 E 222nd St
Rm 205
Euclid, OH 44123
Phone (216) 647-1411

26300 Euclid Ave
Ste 534
Euclid, OH 44132
Phone (216) 261-0000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1230076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728345600000",
    "number": "1275779126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26300 EUCLID AVE STE 534",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441323708",
            "telephone_number": "216-647-1411",
            "fax_number": "216-273-7887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26300 EUCLID AVE STE 534",
            "city": "EUCLID",
            "state": "OH",
            "postal_code": "441323708",
            "telephone_number": "216-647-1411",
            "fax_number": "216-273-7887"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "291 E 222nd St Rm 205",
            "address_purpose": "LOCATION",
            "city": "Euclid",
            "state": "OH",
            "postal_code": "441231718",
            "country_code": "US",
            "telephone_number": "216-647-1411",
            "fax_number": "216-273-7887",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MC GEE",
        "first_name": "GERALD",
        "middle_name": "WISTA",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-12-24",
        "last_updated": "2024-10-08",
        "certification_date": "2024-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0800373",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Euclid, OH

Sources for this page

Verify at the official NPI Registry.