Active NPI
Jonah Gillooly, LICSW
- Clinical Social Worker
- Pittsfield, MA
National Provider Identifier
1346651700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LICSW125433
- Practice address
- 78 Center St FL 2
Pittsfield, MA 01201-5692 - Phone
- (413) 584-4040
- NPI assigned
- May 19, 2014
- Sex
- Male
- 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 | 12294 | AZ | |
| Clinical Social Worker | 1041C0700X | LICSW125433 | MA | Primary |
Addresses
Primary practice location
78 Center St FL 2
Pittsfield, MA 01201-5692
Mailing address
78 Center St FL 2
Pittsfield, MA 01201-5692
Phone (413) 584-4040
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LICSW125433 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sun Life Family Health Center, Inc | Past | Accepting new patients | |
| Sun Life Family Health Center, Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Federally Qualified Health Center (FQHC)
- Casa Grande, AZ
- NPI 1417286568
-
- Federally Qualified Health Center (FQHC)
- Mesa, AZ
- NPI 1508276940
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684195200000",
"number": "1346651700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "78 CENTER ST FL 2",
"city": "PITTSFIELD",
"state": "MA",
"postal_code": "012015692",
"telephone_number": "413-584-4040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "78 CENTER ST FL 2",
"city": "PITTSFIELD",
"state": "MA",
"postal_code": "012015692",
"telephone_number": "413-584-4040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILLOOLY",
"first_name": "JONAH",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-19",
"last_updated": "2023-05-16",
"certification_date": "2023-05-16",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "12294",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "LICSW125433",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pittsfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.