Individual provider Active NPI

Gwendolyn Evan Williams, LCSW

  • Clinical Social Worker
  • Hood River, OR
National Provider Identifier
1558598599
Registry record updated Apr 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L4428 Issued in OR
Practice address
208 State Street
Suite #2
Hood River, OR 97031-2036
Phone
(541) 241-6276
Fax
(360) 844-5184
NPI assigned
Jun 17, 2009
Last updated
Apr 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2026

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 L4428 OR Primary

Addresses

Primary practice location

208 State Street
Suite #2
Hood River, OR 97031-2036

Mailing address

208 State Street
Suite #2
Hood River, OR 97031
Phone (412) 416-2765

Other identifiers 3

IdentifierTypeStateIssuer
R147878OtherORMEDICARE PTAN
500801640MedicaidOR
139670MedicaidOR

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jul 1, 2025 through Jul 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Mid-Columbia Center for Living PastSince Jun 15, 2021 Accepting new patients
Mid-Columbia Center for Living Clinical PastSince Sep 2, 2014 Accepting new patients
Mid-Columbia Center for Living Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1245196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775001600000",
    "number": "1558598599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 STATE STREET",
            "address_2": "SUITE #2",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "97031",
            "telephone_number": "412-416-2765",
            "fax_number": "360-844-5184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 STATE STREET",
            "address_2": "SUITE #2",
            "city": "HOOD RIVER",
            "state": "OR",
            "postal_code": "970312036",
            "telephone_number": "541-241-6276",
            "fax_number": "360-844-5184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "GWENDOLYN",
        "middle_name": "EVAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-17",
        "last_updated": "2026-04-01",
        "certification_date": "2026-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L4428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "R147878",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500801640",
            "state": "OR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "139670",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hood River, OR

Sources for this page

Verify at the official NPI Registry.