Individual provider Active NPI

Wendy Gannett, LICSW

  • Clinical Social Worker
  • Easthampton, MA
National Provider Identifier
1891733408
Registry record updated Apr 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1031429 Issued in MA
Practice address
23 Treehouse Cir
Easthampton, MA 01027-2175
Phone
(413) 320-1620
NPI assigned
Jun 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 10, 2020

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 1031429 MA Primary

Addresses

Primary practice location

23 Treehouse Cir
Easthampton, MA 01027-2175

Mailing address

23 Treehouse Cir
Easthampton, MA 01027-2175
Phone (413) 320-1620

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031106000228 MA Practitioner - Clinical Social Worker 6406769561 Reassigns benefits to 1 organization
Practice locations: Easthampton, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1995
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

23 Treehouse Cir
Suite 1
Easthampton, MA 01027-2175
Phone (413) 535-0550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
River Valley Counseling Center, Inc Clinical CurrentSince Jan 12, 2015 Accepting new patients

Locations

249 Exchange St
Chicopee, MA 01013
Phone (413) 594-2141

303 Beech St
Holyoke, MA 01040
Phone (413) 540-1155

50 Pleasant St
Northampton, MA 01060
Phone (413) 585-1300

Organizations & group practices 1

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": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586476800000",
    "number": "1891733408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 TREEHOUSE CIR",
            "city": "EASTHAMPTON",
            "state": "MA",
            "postal_code": "010272175",
            "telephone_number": "413-320-1620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 TREEHOUSE CIR",
            "city": "EASTHAMPTON",
            "state": "MA",
            "postal_code": "010272175",
            "telephone_number": "413-320-1620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANNETT",
        "first_name": "WENDY",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-04",
        "last_updated": "2020-04-10",
        "certification_date": "2020-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "1031429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easthampton, MA

Sources for this page

Verify at the official NPI Registry.