Individual provider Active NPI

Cheryl Lynn Gay, L.C.S.W.

  • Clinical Social Worker
  • Angola, IN
National Provider Identifier
1851409296
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34004806A Issued in IN
Practice address
200 Hoosier Dr
Suite E
Angola, IN 46703-9345
Phone
(260) 665-9494
Fax
(260) 665-9496
NPI assigned
Aug 27, 2006
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 34004806A IN Primary

Addresses

Primary practice location

200 Hoosier Dr
Suite E
Angola, IN 46703-9345

Mailing address

PO Box 817
Kendallville, IN 46755-0817
Phone (260) 347-2453

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
34004806AINMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851409296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 817",
            "city": "KENDALLVILLE",
            "state": "IN",
            "postal_code": "467550817",
            "telephone_number": "260-347-2453",
            "fax_number": "260-347-2456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HOOSIER DR",
            "address_2": "SUITE E",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467039345",
            "telephone_number": "260-665-9494",
            "fax_number": "260-665-9496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAY",
        "first_name": "CHERYL",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34004806A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Angola, IN

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.