Individual provider Active NPI

Grace Gates, LCSW, LMSW-CLINICAL

  • Clinical Social Worker
  • Livonia, MI
National Provider Identifier
1639620313
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801107131 Issued in MI
Practice address
20222 Farmington Rd
Livonia, MI 48152-1412
Phone
(734) 331-0040
NPI assigned
Oct 18, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 098352 NY
Clinical Social Worker 1041C0700X 089050 NY
Clinical Social Worker 1041C0700X 6801107131 MI Primary

Addresses

Primary practice location

20222 Farmington Rd
Livonia, MI 48152-1412

Mailing address

22710 Haggerty Rd
Farmington Hills, MI 48335-2640

Other practice location 1

22710 Haggerty Rd Ofc 4
Farmington Hills, MI 48335-2640
Phone (734) 331-0040

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201116000997 MI Practitioner - Clinical Social Worker 4880004506 Practice locations: Livonia, MI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
098352NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Pro Therapy Center, PLLC Clinical CurrentSince Feb 7, 2021 Accepting new patients

Locations

22710 Haggerty Rd
Ofc 4
Farmington Hills, MI 48335
Phone (734) 331-0040

22710 Haggerty Rd
Farmington Hills, MI 48335
Phone (734) 331-0040

20222 Farmington Rd
Livonia, MI 48152
Phone (248) 427-4270

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1639620313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22710 HAGGERTY RD",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483352640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20222 FARMINGTON RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481521412",
            "telephone_number": "734-331-0040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "22710 Haggerty Rd Ofc 4",
            "address_purpose": "LOCATION",
            "city": "Farmington Hills",
            "state": "MI",
            "postal_code": "483352640",
            "country_code": "US",
            "telephone_number": "734-331-0040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GATES",
        "first_name": "GRACE",
        "credential": "LCSW, LMSW-CLINICAL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-18",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "098352",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089050",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801107131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

Verify at the official NPI Registry.