Active NPI
Kimberly Lauren Gill, MSW, LCSW, LCSW-C
- Clinical Social Worker
- Eugene, OR
National Provider Identifier
1316470446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- L6194
- Practice address
- 3355 Chad Dr
Eugene, OR 97408-7428 - Phone
- (458) 205-7836
- NPI assigned
- Apr 5, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | L6194 | OR | Primary |
| Clinical Social Worker | 1041C0700X | 17216 | MD |
Addresses
Primary practice location
3355 Chad Dr
Eugene, OR 97408-7428
Mailing address
3355 Chad Dr
Eugene, OR 97408-7428
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| L6194 | OR | MD | Clinical Social Worker |
| 17216 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491350400000",
"number": "1316470446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3355 CHAD DR",
"city": "EUGENE",
"state": "OR",
"postal_code": "974087428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3355 CHAD DR",
"city": "EUGENE",
"state": "OR",
"postal_code": "974087428",
"telephone_number": "458-205-7836"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILL",
"first_name": "KIMBERLY",
"middle_name": "LAUREN",
"name_prefix": "Ms.",
"credential": "MSW, LCSW, LCSW-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-05",
"last_updated": "2017-04-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OR",
"license": "L6194",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "17216",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.