Individual provider Active NPI

Jacqueline Frances Gatz, LMSW

  • Social Worker
  • Birmingham, MI
National Provider Identifier
1376609461
Registry record updated Oct 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801007725 Issued in MI
Practice address
1347 Smith Ave
Birmingham, MI 48009-2039
Phone
(248) 763-6338
Fax
(248) 645-6051
NPI assigned
Dec 31, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801007725 MI Primary
Clinical Social Worker 1041C0700X 6801007725 MI

Addresses

Primary practice location

1347 Smith Ave
Birmingham, MI 48009-2039

Mailing address

1347 Smith Ave
Birmingham, MI 48009-2039
Phone (248) 763-6338

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

NPI Registry JSON

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

{
    "created_epoch": "1167523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319587200000",
    "number": "1376609461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1347 SMITH AVE",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480092039",
            "telephone_number": "248-763-6338",
            "fax_number": "248-645-6051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1347 SMITH AVE",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480092039",
            "telephone_number": "248-763-6338",
            "fax_number": "248-645-6051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATZ",
        "first_name": "JACQUELINE",
        "middle_name": "FRANCES",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-31",
        "last_updated": "2011-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801007725",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801007725",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; 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.