Theresa R Gibson, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801081687 Issued in MI

Practice address

156 S 3Rd St
Rogers City, MI 49779-1710

Phone

(989) 255-3505

NPI assigned

Oct 28, 2008

Last updated

Dec 26, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

Specialty

Clinical Social Worker

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northeast Michigan Community Mental Health Authority

  • Community/Behavioral Health Agency
  • Alpena, MI
  • NPI 1144378381
  Medicare reassignment NPD

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

{
    "created_epoch": "1225152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608940800000",
    "number": "1942453519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "156 S 3RD ST",
            "city": "ROGERS CITY",
            "state": "MI",
            "postal_code": "497791710",
            "telephone_number": "989-255-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "156 S 3RD ST",
            "city": "ROGERS CITY",
            "state": "MI",
            "postal_code": "497791710",
            "telephone_number": "989-255-3505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIBSON",
        "first_name": "THERESA",
        "middle_name": "R",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-28",
        "last_updated": "2020-12-26",
        "certification_date": "2020-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801081687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "na",
            "affiliation": "N",
            "endpointDescription": "na",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "na",
            "address_1": "366 S Third St",
            "city": "Rogers City",
            "state": "MI",
            "country_code": "US",
            "postal_code": "497791809",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• FMG North Bradley Highway Michigan LLC (Tendercare Health Center - Rogers City)
• Gajewski Inc
• Gajewski Inc (McLean Pharmacy)
• Thomas Leo Gajewski, PHARMD
• Jennifer Geyer, LPTA
• Jami Lee Grosberg, FNP-C
• Lauren Hanson
• Marion C Hautea, M.D.
• Tamyra Henigan, CFNP
• Anthony Hitchcock

• Clinical Social Worker in Rogers City, MI
• Providers in Rogers City, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.