Kathryn Gandolph, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

19844 Issued in MN

Practice address

2230 Como Ave
Saint Paul, MN 55108-1720

Phone

(651) 645-5323

Fax

(651) 641-6190

NPI assigned

Mar 14, 2012

Last updated

Mar 14, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1331683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331683200000",
    "number": "1891060562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081720",
            "telephone_number": "651-645-5323",
            "fax_number": "651-641-6190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 COMO AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551081720",
            "telephone_number": "651-645-5323",
            "fax_number": "651-641-6190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDOLPH",
        "first_name": "KATHRYN",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-14",
        "last_updated": "2012-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "19844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gambiye Transportation Inc
• Edgar James Gambrell III
• Jennifer Gambucci, LICSW
• Morli J Gamm, CRNA
• Helen Jane Gammon, LICSW
• Vathsala Ganeshan, MD
• Kathleen M Gang, MD
• Angel Mei Ganz, PHARMD
• Robert A Ganz, MD
• Mengze Gao, PSYD LP

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; 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.