Active NPI
Catherine Gayle, PHD LCSW
- Clinical Social Worker
- Lagrange, GA
National Provider Identifier
1407017072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW002414
- Practice address
- 111B Corporate Park East Dr
Lagrange, GA 30241-3680 - Phone
- (706) 884-1080
- Fax
- (706) 812-8866
- NPI assigned
- Jun 17, 2008
- Last updated
- Jun 17, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW002414 | GA | Primary |
Addresses
Primary practice location
111B Corporate Park East Dr
Lagrange, GA 30241-3680
Mailing address
111B Corporate Park East Dr
Lagrange, GA 30241-3680
Phone (706) 884-1080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 514073675A | Medicaid | GA |
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW002414 | GA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Center for Creative Growth and Human Development, Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Lagrange, GA
- NPI 1205027398
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213660800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213660800000",
"number": "1407017072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111B CORPORATE PARK EAST DR",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "302413680",
"telephone_number": "706-884-1080",
"fax_number": "706-812-8866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111B CORPORATE PARK EAST DR",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "302413680",
"telephone_number": "706-884-1080",
"fax_number": "706-812-8866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GAYLE",
"first_name": "CATHERINE",
"name_prefix": "Dr.",
"credential": "PHD LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-17",
"last_updated": "2008-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW002414",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "514073675A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lagrange, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.