Individual provider Active NPI

Gayle L. Clelland, LCSW

  • Clinical Social Worker
  • Sebastian, FL
National Provider Identifier
1598842528
Registry record updated Mar 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW9419 Issued in FL
Practice address
620 Helicon Ter
Sebastian, FL 32958-5954
Phone
(772) 643-2838
NPI assigned
Nov 1, 2006
Last updated
Mar 16, 2011By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2011

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 SW9419 FL Primary

Addresses

Primary practice location

620 Helicon Ter
Sebastian, FL 32958-5954

Mailing address

620 Helicon Ter
Sebastian, FL 32958-5954
Phone (772) 643-2838

Other identifiers 1

IdentifierTypeStateIssuer
1184934671OtherFLCORPORATE NATIONAL PROVIDER IDENTIFIER

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW9419FLMDClinical Social Worker

Organizations & group practices 1

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": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1300233600000",
    "number": "1598842528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 HELICON TER",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329585954",
            "telephone_number": "772-643-2838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 HELICON TER",
            "city": "SEBASTIAN",
            "state": "FL",
            "postal_code": "329585954",
            "telephone_number": "772-643-2838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLELLAND",
        "first_name": "GAYLE",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2011-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW9419",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORPORATE NATIONAL PROVIDER IDENTIFIER",
            "identifier": "1184934671",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sebastian, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.