Ian Gackowski, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301017272 Issued in MI

Practice address

120 E Liberty St Ste 300D
Ann Arbor, MI 48104-2163

Phone

(269) 370-1868

NPI assigned

Jan 4, 2019

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1546560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549756800000",
    "number": "1356814115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 ARBOR CIR W APT 108",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481973450",
            "telephone_number": "269-370-1868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E LIBERTY ST STE 300D",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481042163",
            "telephone_number": "269-370-1868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "609 Tappan Ave",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481091220",
            "country_code": "US",
            "telephone_number": "734-764-8312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GACKOWSKI",
        "first_name": "IAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-01-04",
        "last_updated": "2019-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301017272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Samuel Olimpiu Gabor, PHARMD
• Brooke Gabriel, LMSW
• Cynthia Anne Gabriel, CLD
• Kalie Gabriel
• William James Gabriel, M. D.
• Heba Taha Mohammed Gad, M.D.
• Ibtissam Mohammad Gad, MD
• Dana M Gadaire, PSYD
• Swetha Gaddam, MBBS
• Samir Gadepalli, MD

• Psychologist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.