Active NPI
David Gish, LCSW
- Clinical Social Worker
- Chicago, IL
National Provider Identifier
1629311808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149015834
- Practice address
- 3024 N Ashland Ave Unit 578124
Chicago, IL 60657-7705 - Phone
- (312) 970-0147
- NPI assigned
- Apr 5, 2013
- Sex
- Male
- Sole proprietor
- Yes
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 | 149015834 | IL | Primary |
Addresses
Primary practice location
3024 N Ashland Ave Unit 578124
Chicago, IL 60657-7705
Mailing address
3024 N Ashland Ave Unit 578124
Chicago, IL 60657-7705
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 6, 2025 through Feb 6, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1365120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698969600000",
"number": "1629311808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3024 N ASHLAND AVE UNIT 578124",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606577705"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3024 N ASHLAND AVE UNIT 578124",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606577705",
"telephone_number": "312-970-0147"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GISH",
"first_name": "DAVID",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-04-05",
"last_updated": "2023-11-03",
"certification_date": "2023-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149015834",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.