Gayle Van Horn, MSW, LCSW, LISW, LIP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C005158 Issued in NC

Practice address

12415 Shelly Pines Dr
Charlotte, NC 28262-1034

Phone

(704) 608-3760

NPI assigned

Oct 28, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NC

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.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

MonarchGroup PAC ID 0244273852, 92 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Monarch

  • Community/Behavioral Health Agency
  • Albemarle, NC
  • NPI 1801116405
  Medicare reassignment Care Compare group NPD
• Monarch

  • Community/Behavioral Health Agency
  • Wilmington, NC
  • NPI 1073267126
  NPD
• Monarch

  • Community/Behavioral Health Agency
  • Wilson, NC
  • NPI 1619317823
  NPD
• Progressive Recovery Resources Homes LLC

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Charlotte, NC
  • NPI 1851072169
  NPD

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

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393545600000",
    "number": "1306172184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12415 SHELLY PINES DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282621034",
            "telephone_number": "704-596-5553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12415 SHELLY PINES DR",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282621034",
            "telephone_number": "704-608-3760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN HORN",
        "first_name": "GAYLE",
        "credential": "MSW, LCSW, LISW, LIP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-10-28",
        "last_updated": "2014-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C005158",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "C005158",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SC",
            "license": "10365",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED INDEPENDENT SOCIAL WORKER",
            "identifier": "10365",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6006204",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michel McClamrock Van Devender, MSW, LCSW
• Maria Araceli Van Dyke, LCMHC
• Susannah Bauer Van Dyke, NP
• Sandy Charles Van Every, PA-C
• John Ronald Van Gurp, M.D.
• Leslie Thompson Van Horn, RDN, LDN
• Zoe Van Kirk, LCMHCA
• Alyssa Rose Van Meter, PA
• Marybeth Van Nest
• Mark Daniel Van Poppel, M.D.

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.