Active NPI
Gretchen Ann Mims, LMSW, PH.D
- School Social Worker
- North Chili, NY
National Provider Identifier
1639455348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- License
- 072120-1
- Practice address
- 81 Bolton TRL
North Chili, NY 14514-9774 - Phone
- (585) 889-6429
- NPI assigned
- Oct 26, 2011
- Sex
- Female
- 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 |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | 072120-1 | NY | Primary |
Addresses
Primary practice location
81 Bolton TRL
North Chili, NY 14514-9774
Mailing address
81 Bolton TRL
North Chili, NY 14514-9774
Phone (585) 889-6429
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 072120-1 | NY | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319587200000",
"number": "1639455348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "81 BOLTON TRL",
"city": "NORTH CHILI",
"state": "NY",
"postal_code": "145149774",
"telephone_number": "585-889-6429"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "81 BOLTON TRL",
"city": "NORTH CHILI",
"state": "NY",
"postal_code": "145149774",
"telephone_number": "585-889-6429"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIMS",
"first_name": "GRETCHEN",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "LMSW, PH.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-26",
"last_updated": "2011-10-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "NY",
"license": "072120-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in North Chili, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 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.