Individual provider Active NPI

Gina Justice, LCSW

  • Clinical Social Worker
  • Williamson, WV
National Provider Identifier
1730586470
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
DP00944247 Issued in WV
Practice address
184 E 2ND Ave Ste 1
Williamson, WV 25661-3602
Phone
(304) 236-5902
Fax
(855) 487-4047
NPI assigned
Nov 24, 2014
Last updated
Dec 17, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 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 DP00944247 WV Primary

Addresses

Primary practice location

184 E 2ND Ave Ste 1
Williamson, WV 25661-3602

Mailing address

PO Box 2080
Williamson, WV 25661-2080
Phone (304) 236-5902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20160104000079 WV Practitioner - Clinical Social Worker 3678875044 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Williamson Health & Wellness Center Inc CurrentSince Nov 7, 2015 Accepting new patients
Williamson Health & Wellness Center Inc CurrentSince Nov 7, 2015 Accepting new patients
Williamson Health & Wellness Center Inc CurrentSince Mar 1, 2021 Accepting new patients

Locations

104 Logan St
Williamson, WV 25661
Phone (304) 235-0146

104 Logan St
Ste B
Williamson, WV 25661

184 E 2nd Ave
Williamson, WV 25661
Phone (304) 235-1844

184 E 2nd Ave
Ste 1
Williamson, WV 25661
Phone (304) 235-1844

184 E 2nd Ave
Ste 201
Williamson, WV 25661

184 E 2nd Ave
Ste 210
Williamson, WV 25661

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1416787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1730586470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2080",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256612080",
            "telephone_number": "304-236-5902",
            "fax_number": "304-909-3174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 E 2ND AVE STE 1",
            "city": "WILLIAMSON",
            "state": "WV",
            "postal_code": "256613602",
            "telephone_number": "304-236-5902",
            "fax_number": "855-487-4047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUSTICE",
        "first_name": "GINA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-24",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00944247",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamson, WV

Sources for this page

Verify at the official NPI Registry.