Active NPI
Laura L Gotham, ACSW
- Social Worker
- Sandusky, MI
National Provider Identifier
1497844013
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6801088110
- Practice address
- 190 N Delaware St
Sandusky, MI 48471-1009 - Phone
- (810) 583-0313
- NPI assigned
- Oct 12, 2006
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801088110 | MI | Primary |
Addresses
Primary practice location
190 N Delaware St
Sandusky, MI 48471-1009
Mailing address
1978 Woodland Estates Dr
Saint Clair, MI 48079-5599
Phone (810) 326-4699
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801088110 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1497844013",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1978 WOODLAND ESTATES DR",
"city": "SAINT CLAIR",
"state": "MI",
"postal_code": "480795599",
"telephone_number": "810-326-4699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "190 N DELAWARE ST",
"city": "SANDUSKY",
"state": "MI",
"postal_code": "484711009",
"telephone_number": "810-583-0313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOTHAM",
"first_name": "LAURA",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "ACSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-12",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801088110",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandusky, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.