Individual provider Active NPI

Jennifer Gale Gillette, LMSW, OSW-C

  • Clinical Social Worker
  • Southfield, MI
National Provider Identifier
1902966518
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801081393 Issued in MI
Practice address
22301 Foster Winter Dr
3Rd Floor
Southfield, MI 48075-3707
Phone
(248) 849-3243
Fax
(248) 849-2919
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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 6801081393 MI Primary

Addresses

Primary practice location

22301 Foster Winter Dr
3Rd Floor
Southfield, MI 48075-3707

Mailing address

1157 Shadow Dr
Troy, MI 48085-1779
Phone (248) 224-2930

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
I20180420001491 MI Practitioner - Clinical Social Worker 3678836806 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thrive Counseling LLCGroup PAC ID 0749458420, 1,187 clinicians

Practice addresses (Care Compare)

1555 W Big Beaver Rd
Troy, MI 48084-3525
Phone (248) 764-4182

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801081393MIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive Counseling LLC CurrentSince Sep 21, 2023 Accepting new patients
Illuminations Christian Counseling, PLLC PastSince Sep 24, 2023 Accepting new patients

Locations

7333 Triangle Dr
Sterling Hts, MI 48314
Phone (248) 686-3347

1555 W Big Beaver Rd
Troy, MI 48084
Phone (248) 764-4182

1000 Jefferson St
Ste 2C
Lynchburg, VA 24504
Phone (434) 528-3263

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": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1902966518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1157 SHADOW DR",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480851779",
            "telephone_number": "248-224-2930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22301 FOSTER WINTER DR",
            "address_2": "3RD FLOOR",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753707",
            "telephone_number": "248-849-3243",
            "fax_number": "248-849-2919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLETTE",
        "first_name": "JENNIFER",
        "middle_name": "GALE",
        "name_prefix": "Mrs.",
        "credential": "LMSW, OSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801081393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

Verify at the official NPI Registry.