Active NPI
Kimberly L Gerlach, LCSW
- Psychologist
- Milwaukee, WI
National Provider Identifier
1578623906
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4236123
- Practice address
- 9000 W Wisconsin Ave
Milwaukee, WI 53201 - Phone
- (414) 266-2923
- Fax
- (414) 266-3735
- NPI assigned
- Dec 8, 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 4236123 | WI | Primary |
Addresses
Primary practice location
9000 W Wisconsin Ave
Milwaukee, WI 53201
Mailing address
Pob 1997 Ms 750
Milwaukee, WI 53201
Phone (414) 266-2423
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 39513800 | Medicaid | WI |
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 |
|---|---|---|---|
| 4236123 | WI | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578623906",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "POB 1997 MS 750",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "53201",
"telephone_number": "414-266-2423",
"fax_number": "414-266-3735"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9000 W WISCONSIN AVE",
"city": "MILWAUKEE",
"state": "WI",
"postal_code": "53201",
"telephone_number": "414-266-2923",
"fax_number": "414-266-3735"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERLACH",
"first_name": "KIMBERLY",
"middle_name": "L",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WI",
"license": "4236123",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "39513800",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Milwaukee, WI
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.