Active NPI
Gina Diane Gills, MSW, LCSW
- Clinical Social Worker
- Boulder, CO
National Provider Identifier
1851604938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 1221
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 1221 | CO | MD | Clinical 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.