Individual provider Active NPI

Merrilyn Rose Gill, LCSW, LCAS

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1467405563
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C003246 Issued in NC
Practice address
3111 Springbank LN
Suite G
Charlotte, NC 28226-3372
Phone
(704) 540-1706
Fax
(704) 540-5866
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C003246 NC Primary

Addresses

Primary practice location

3111 Springbank LN
Suite G
Charlotte, NC 28226-3372

Mailing address

3315 Springbank LN Ste 106
Charlotte, NC 28226-3198
Phone (704) 540-1706

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041027001091 NC Practitioner - Clinical Social Worker 8224090733 Practice locations: Charlotte, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

3315 Springbank LN
Suite 106
Charlotte, NC 28226-3198
Phone (704) 540-1706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C003246NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
University Psychiatric Associates P.a. 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1467405563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3315 SPRINGBANK LN STE 106",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282263198",
            "telephone_number": "704-540-1706",
            "fax_number": "980-819-5798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3111 SPRINGBANK LN",
            "address_2": "SUITE G",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282263372",
            "telephone_number": "704-540-1706",
            "fax_number": "704-540-5866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILL",
        "first_name": "MERRILYN",
        "middle_name": "ROSE",
        "credential": "LCSW,  LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C003246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.