Brian Gary, SOCIAL WORK
Individual provider Active NPI Social Worker · Bagley, MN
NPI 1346520145 · NPPES record last updated Aug 24, 2011
Key facts
- NPI
- 1346520145
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- Practice address
- 216 Park Ave NW
PO Box X
Bagley, MN 56621-9500 - Phone
- (218) 694-6164
- Fax
- (218) 694-3535
- NPI assigned
- Aug 24, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clearwater County Department of Human Services | Past | Accepting new patients | |
| Upper Mississippi Mental Health Center, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | MN | Yes |
Addresses
Primary practice location
216 Park Ave NW
PO Box X
Bagley, MN 56621-9500
Mailing address
216 Park Ave NW
PO Box X
Bagley, MN 56621-9500
Phone (218) 694-6164
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 27 | Other | SOCIAL SERVICES |
Other providers in Bagley, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.