Individual provider Active NPI

Gabrielle Vanwert, MA

  • Psychologist
  • Lansing, MI
National Provider Identifier
1851946057
Registry record updated Sep 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
6362010027 Issued in MI
Practice address
1717 N High St
Lansing, MI 48906-4529
Phone
(517) 372-4700
NPI assigned
Aug 5, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 6362010027 MI Primary
Case Manager/Care Coordinator 171M00000X

Addresses

Primary practice location

1717 N High St
Lansing, MI 48906-4529

Mailing address

1717 N High St
Lansing, MI 48906-4597
Phone (517) 320-2420

Other practice location 1

6692 Spring Arbor Rd
Jackson, MI 49201-9812
Phone (517) 750-3869

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6362010027MIMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Cristo Rey Community Center PastSince Aug 11, 2019 Accepting new patients
Catholic Charities of Ingham, Eaton and Clinton Counties PastSince Aug 11, 2019 Accepting new patients

Organizations & group practices 2

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": "1564963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1851946057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 N HIGH ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489064597",
            "telephone_number": "517-320-2420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 N HIGH ST",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489064529",
            "telephone_number": "517-372-4700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6692 Spring Arbor Rd",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MI",
            "postal_code": "492019812",
            "country_code": "US",
            "telephone_number": "517-750-3869",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANWERT",
        "first_name": "GABRIELLE",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-05",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6362010027",
            "primary": true
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.