Individual provider Active NPI

Gina Diane Gills, MSW, LCSW

  • Clinical Social Worker
  • Boulder, CO
National Provider Identifier
1851604938
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1221 Issued in CO
Practice address
3450 Broadway St
Boulder, CO 80304
Phone
(303) 441-1100
NPI assigned
Jul 19, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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 1221 CO Primary

Addresses

Primary practice location

3450 Broadway St
Boulder, CO 80304

Mailing address

405 W Cannon St
Lafayette, CO 80026-1611
Phone (720) 318-8866

Other practice location 1

3450 Broadway St
Boulder, CO 80304-1824
Phone (303) 441-1100

Other practice location 2

80 Garden Ctr Ste 46
Broomfield, CO 80020-1777
Phone (720) 318-8866

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
1221COMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536105600000",
    "number": "1851604938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 W CANNON ST",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800261611",
            "telephone_number": "720-318-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80304",
            "telephone_number": "303-441-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3450 Broadway St",
            "address_purpose": "LOCATION",
            "city": "Boulder",
            "state": "CO",
            "postal_code": "803041824",
            "country_code": "US",
            "telephone_number": "303-441-1100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 Garden Ctr Ste 46",
            "address_purpose": "LOCATION",
            "city": "Broomfield",
            "state": "CO",
            "postal_code": "800201777",
            "country_code": "US",
            "telephone_number": "720-318-8866",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLS",
        "first_name": "GINA",
        "middle_name": "DIANE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-19",
        "last_updated": "2018-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "1221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boulder, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; 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.