Individual provider Active NPI

Camella Gild, LMSW, ACSW

  • Clinical Social Worker
  • Port Huron, MI
National Provider Identifier
1902902117
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
L861213 Issued in MI
Practice address
2601 13TH St
Port Huron, MI 48060-6546
Phone
(810) 987-9100
Fax
(810) 987-9105
NPI assigned
Sep 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 L861213 MI Primary

Addresses

Primary practice location

2601 13TH St
Port Huron, MI 48060-6546

Mailing address

2601 13TH St
Port Huron, MI 48060-6546
Phone (810) 987-9100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20131114001575 MI Practitioner - Clinical Social Worker 3072749373 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Catholic Charities of Southeast MichiganGroup PAC ID 0042450553, 7 clinicians

Practice addresses (Care Compare)

2601 13TH St
Port Huron, MI 48060-6546
Phone 81098791005002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L861213MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Catholic Charities of Southeast Michigan Clinical CurrentSince Aug 19, 2013 Accepting new patients

Locations

2601 13th St
Port Huron, MI 48060
Phone (810) 987-9100

24445 Northwestern Hwy
Ste 200
Southfield, MI 48075
Phone (248) 850-1998

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": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902902117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2601 13TH ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606546",
            "telephone_number": "810-987-9100",
            "fax_number": "810-987-9105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 13TH ST",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480606546",
            "telephone_number": "810-987-9100",
            "fax_number": "810-987-9105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILD",
        "first_name": "CAMELLA",
        "name_prefix": "Ms.",
        "credential": "LMSW, ACSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "L861213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.