Gary Carroll Faith, LCSW LICENSED CLINIC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

IP640 Issued in TN

Practice address

331 22ND Ave North
Suite 1
Nashville, TN 37203

Phone

(615) 329-9809

Fax

(615) 523-1322

NPI assigned

Aug 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1922118587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 22ND AVE NORTH",
            "address_2": "SUITE 1 GARY FAITH LCSW",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37203",
            "telephone_number": "615-329-9809",
            "fax_number": "615-523-1322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 22ND AVE NORTH",
            "address_2": "SUITE 1",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "37203",
            "telephone_number": "615-329-9809",
            "fax_number": "615-523-1322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAITH",
        "first_name": "GARY",
        "middle_name": "CARROLL",
        "credential": "LCSW LICENSED CLINIC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "IP640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0076270",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3692480",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Faith Family Medical Clinic
• Faith Heals Mobile Wound Care
• Faith Heals Mobile Wound Care
• Faith Home Healthcare, LLC
• Faith Speech, Language, & Swallowing SVCS
• Faithful Transportation Services LLC
• Faithway Transportation
• Kristen Dianna Fajgenbaum, MD
• Amna Fakhar
• Jessica Marie Fakhoury

• Clinical Social Worker in Nashville, TN
• Providers in Nashville, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.