Individual provider Active NPI

Ruth A Garvin, LCSW CSAC

  • Clinical Social Worker
  • Marshfield, WI
National Provider Identifier
1467770594
Registry record updated Feb 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
128564-121 Issued in WI
Practice address
1905 S Central Ave
Marshfield, WI 54449-4917
Phone
(715) 898-1665
NPI assigned
May 13, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 14680-132 WI
Clinical Social Worker 1041C0700X 128564-121 WI Primary

Addresses

Primary practice location

1905 S Central Ave
Marshfield, WI 54449-4917

Mailing address

125 Fillmore St
Black River Falls, WI 54615-1740
Phone (715) 898-1665

Other identifiers 1

IdentifierTypeStateIssuer
39174000MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: No
  • 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
I20180612001934 WI Practitioner - Clinical Social Worker 9133474364 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14680-132WIMDAddiction (Substance Use Disorder) Counselor
128564-121WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Gateways Counseling Services, Inc Addiction (Substance Use Disorder) CurrentSince Jun 5, 2021 Accepting new patients

Locations

125 Fillmore St
Black River Falls, WI 54615
Phone (715) 898-1665

1905 S Central Ave
Marshfield, WI 54449
Phone (715) 898-1665

Organizations & group practices 2

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": "1273708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644969600000",
    "number": "1467770594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 FILLMORE ST",
            "city": "BLACK RIVER FALLS",
            "state": "WI",
            "postal_code": "546151740",
            "telephone_number": "715-898-1665",
            "fax_number": "715-898-1240"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1905 S CENTRAL AVE",
            "city": "MARSHFIELD",
            "state": "WI",
            "postal_code": "544494917",
            "telephone_number": "715-898-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARVIN",
        "first_name": "RUTH",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LCSW CSAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-13",
        "last_updated": "2022-02-16",
        "certification_date": "2021-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "14680-132",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "128564-121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39174000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshfield, WI

Sources for this page

Verify at the official NPI Registry.