Individual provider Active NPI

Lou A Gamalski, LMSW

  • Clinical Social Worker
  • Traverse City, MI
National Provider Identifier
1922417906
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801093636 Issued in MI
Practice address
124 Munson Ave
Traverse City, MI 49686-3038
Phone
(248) 496-6530
Fax
(833) 268-8214
NPI assigned
Aug 4, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X MI
Clinical Social Worker 1041C0700X 6801093636 MI Primary

Addresses

Primary practice location

124 Munson Ave
Traverse City, MI 49686-3038

Mailing address

PO Box 11
Kewadin, MI 49648-0011
Phone (248) 496-6530

Other practice location 1

850 N Mitchell St Ste B
Cadillac, MI 49601-1488
Phone (248) 496-6530

Other identifiers 2

IdentifierTypeStateIssuer
12770182OtherCAQH
1790459899MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6801093636MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1407110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1922417906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11",
            "city": "KEWADIN",
            "state": "MI",
            "postal_code": "496480011",
            "telephone_number": "248-496-6530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 MUNSON AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496863038",
            "telephone_number": "248-496-6530",
            "fax_number": "833-268-8214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "850 N Mitchell St Ste B",
            "address_purpose": "LOCATION",
            "city": "Cadillac",
            "state": "MI",
            "postal_code": "496011488",
            "country_code": "US",
            "telephone_number": "248-496-6530",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAMALSKI",
        "first_name": "LOU",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-04",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801093636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12770182",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1790459899",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2024; 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.