Active NPI
Gary James Engelhardt, SOCIAL WORKER
- Clinical Social Worker
- Wooster, OH
National Provider Identifier
1497868004
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- I 0009373
- Practice address
- 124 N Walnut St
Wooster, OH 44691-4808 - Phone
- (330) 262-1001
- NPI assigned
- Aug 16, 2006
- 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 | I 0009373 | OH | Primary |
Addresses
Primary practice location
124 N Walnut St
Wooster, OH 44691-4808
Mailing address
701 N Bever St
Wooster, OH 44691-2909
Phone (330) 345-7914
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 |
|---|---|---|---|
| I 0009373 | OH | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1497868004",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "701 N BEVER ST",
"city": "WOOSTER",
"state": "OH",
"postal_code": "446912909",
"telephone_number": "330-345-7914"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "124 N WALNUT ST",
"city": "WOOSTER",
"state": "OH",
"postal_code": "446914808",
"telephone_number": "330-262-1001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ENGELHARDT",
"first_name": "GARY",
"middle_name": "JAMES",
"credential": "SOCIAL WORKER",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "OH",
"license": "I 0009373",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wooster, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.