Michael H Gillooly, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

05028 Issued in MD

Practice address

1538 Chapman Rd
Crofton, MD 21114-3100

Phone

(301) 261-3574

Fax

(410) 721-3436

NPI assigned

Jan 8, 2007

Last updated

Jul 13, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

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, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405209600000",
    "number": "1336297472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1538 CHAPMAN RD",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211143100",
            "telephone_number": "301-261-3574",
            "fax_number": "410-721-3436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1538 CHAPMAN RD",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211143100",
            "telephone_number": "301-261-3574",
            "fax_number": "410-721-3436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLOOLY",
        "first_name": "MICHAEL",
        "middle_name": "H",
        "name_prefix": "Mr.",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2014-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "05028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "076639",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arisa George
• Katayoun D Ghajarnia, DMD
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• Anais Claire Gillian, MS, LCPC, LPC
• Jackie L. Gilliard, M.D.
• Kenneth Warren Gilstein, PH.D.
• Ronald J Gloston Jr., PSY.D.
• Jasmine S Glover
• Josiah Goble, BCBA
• Hana Godana

• Clinical Social Worker in Crofton, MD
• Providers in Crofton, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 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.