Individual provider Active NPI

Gabrielle Vanduser, LMSW

  • Clinical Social Worker
  • Syracuse, NY
National Provider Identifier
1639973324
Registry record updated Apr 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
126567 Issued in NY
Practice address
719 Harrison St
Syracuse, NY 13210-2695
Phone
(315) 464-3265
NPI assigned
Apr 2, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2025

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 126567 NY Primary

Addresses

Primary practice location

719 Harrison St
Syracuse, NY 13210-2695

Mailing address

28 Elderkin Ave
Camillus, NY 13031-1024
Phone (315) 367-8018

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

State licenses

LicenseStateTypeSpecialty
126567NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Psychiatry Faculty Practice, Inc. CurrentSince Apr 6, 2025 Accepting new patients

Locations

719 Harrison St
Syracuse, NY 13210
Phone (315) 464-3265

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": "1743552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743552000000",
    "number": "1639973324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 ELDERKIN AVE",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130311024",
            "telephone_number": "315-367-8018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 HARRISON ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132102695",
            "telephone_number": "315-464-3265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDUSER",
        "first_name": "GABRIELLE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-02",
        "last_updated": "2025-04-02",
        "certification_date": "2025-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "126567",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2025; 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.