Individual provider Active NPI

Christina Gerlach, L.C.S.W.

  • Clinical Social Worker
  • Peoria, IL
National Provider Identifier
1841321957
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
330 SW Washington St
Counseling & Family Services
Peoria, IL 61602-1417
Phone
(309) 676-2400
Fax
(309) 676-6037
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 IL Primary

Addresses

Primary practice location

330 SW Washington St
Counseling & Family Services
Peoria, IL 61602-1417

Mailing address

330 SW Washington St
Counseling & Family Services
Peoria, IL 61602-1417
Phone (309) 676-2400

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
149.011916ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Counseling & Family Services Past Accepting new patients

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1841321957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 SW WASHINGTON ST",
            "address_2": "COUNSELING & FAMILY SERVICES",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021417",
            "telephone_number": "309-676-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 SW WASHINGTON ST",
            "address_2": "COUNSELING & FAMILY SERVICES",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616021417",
            "telephone_number": "309-676-2400",
            "fax_number": "309-676-6037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERLACH",
        "first_name": "CHRISTINA",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.