Active NPI
Joel David Gibson
- Clinical Social Worker
- New Richmond, WI
National Provider Identifier
1417115262
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 7434-123
- Practice address
- 1445 N 4TH St
New Richmond, WI 54017-1063 - Phone
- (715) 246-6991
- Fax
- (715) 246-8440
- NPI assigned
- May 29, 2008
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 7434-123 | WI | Primary |
Addresses
Primary practice location
1445 N 4TH St
New Richmond, WI 54017-1063
Mailing address
1445 N 4TH St
New Richmond, WI 54017-1063
Phone (715) 246-6991
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 |
|---|---|---|---|
| 7434 | WI | MD | Mental Health Counselor |
| 7434-123 | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212019200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212019200000",
"number": "1417115262",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1445 N 4TH ST",
"city": "NEW RICHMOND",
"state": "WI",
"postal_code": "540171063",
"telephone_number": "715-246-6991",
"fax_number": "715-246-8440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1445 N 4TH ST",
"city": "NEW RICHMOND",
"state": "WI",
"postal_code": "540171063",
"telephone_number": "715-246-6991",
"fax_number": "715-246-8440"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "JOEL",
"middle_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-29",
"last_updated": "2008-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "7434-123",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Richmond, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.