Individual provider Active NPI

Gay E. Jurgens, M.S.S.W.

  • Clinical Social Worker
  • Dallas, TX
National Provider Identifier
1851594881
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
10210 Issued in TX
Practice address
3850 Northaven Rd
Dallas, TX 75229-2733
Phone
(214) 352-8262
NPI assigned
Jun 7, 2007
Sex
Female
Sole proprietor
Yes

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 10210 TX Primary

Addresses

Primary practice location

3850 Northaven Rd
Dallas, TX 75229-2733

Mailing address

3850 Northaven Rd
Dallas, TX 75229-2733
Phone (214) 352-8262

Other identifiers 1

IdentifierTypeStateIssuer
00S56EOtherTXBCBS

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
10210TXMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851594881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 NORTHAVEN RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752292733",
            "telephone_number": "214-352-8262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 NORTHAVEN RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752292733",
            "telephone_number": "214-352-8262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JURGENS",
        "first_name": "GAY",
        "middle_name": "E.",
        "credential": "M.S.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TX",
            "license": "10210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00S56E",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

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.