Alexis Michael Gully, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

34005217A Issued in IN

Practice address

25 Beachway Dr
Suite C
Indianapolis, IN 46224-8506

Phone

(317) 788-4111

NPI assigned

Mar 20, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Alexis Michael Bailey Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Supportive Systems

  • Community/Behavioral Health Agency
  • Indianapolis, IN
  • NPI 1932460987
  NPD (past)
• Supportive Systems, LLC

  • Clinical Social Worker
  • Indianapolis, IN
  • NPI 1871771493
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1598880320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7334 HARBOUR ISLE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462403471",
            "telephone_number": "801-694-3836"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 BEACHWAY DR",
            "address_2": "SUITE C",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462248506",
            "telephone_number": "317-788-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GULLY",
        "first_name": "ALEXIS",
        "middle_name": "MICHAEL",
        "name_prefix": "Mrs.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "379250-3501",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005217A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "BAILEY",
            "middle_name": "MICHAEL",
            "prefix": "MRS.",
            "credential": "MSW, LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kaeli Gulley
• Amber N Gullion, NP
• Shannon Michelle Gullion, FNP
• David J Gulliver, MD
• Hitesh Gulliya, DO
• Carolyn Jean Gum, M.S.,P.T.
• Gwyn Gumalo
• Jerelyn J. Gumerson, NP
• Chloe Gumm
• Brittany Nicole Gummere, MSW

• Clinical Social Worker in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Clinical Social Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.