Individual provider Active NPI

Gary Scott Wolk, LCSW-R, CASAC, CGP

  • Addiction (Substance Use Disorder) Counselor
  • Rochester, NY
National Provider Identifier
1780653931
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
5666 Issued in NY
Practice address
16 N Goodman St
Rochester, NY 14607-1554
Phone
(585) 546-6560
NPI assigned
Mar 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 5666 NY Primary
Clinical Social Worker 1041C0700X R058024 NY

Addresses

Primary practice location

16 N Goodman St
Rochester, NY 14607-1554

Mailing address

114 High St
Avon, NY 14414-1006
Phone (585) 226-3842

Other identifiers 3

IdentifierTypeStateIssuer
02561291MedicaidNY
114045FKOtherNYPREFERRED CARE/MVP HEALTH
7758505OtherNYAETNA PPO/POS (PIN)

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5666NYMDAddiction (Substance Use Disorder) Counselor
R058024NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1142553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1780653931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 HIGH ST",
            "city": "AVON",
            "state": "NY",
            "postal_code": "144141006",
            "telephone_number": "585-226-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 N GOODMAN ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146071554",
            "telephone_number": "585-546-6560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLK",
        "first_name": "GARY",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "LCSW-R, CASAC, CGP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-17",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "5666",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R058024",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02561291",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CARE/MVP HEALTH",
            "identifier": "114045FK",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO/POS (PIN)",
            "identifier": "7758505",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.