Active NPI
Lacey Gale, LICSW
- Clinical Social Worker
- Minneapolis, MN
National Provider Identifier
1992139661
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 17533
- Practice address
- 2430 Nicollet Ave South
Washburn Center for Children
Minneapolis, MN 55404 - Phone
- (612) 871-1454
- Fax
- (612) 871-1505
- NPI assigned
- Aug 29, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 17533 | MN | Primary |
Addresses
Primary practice location
2430 Nicollet Ave South
Washburn Center for Children
Minneapolis, MN 55404
Mailing address
2430 Nicollet Ave South
Washburn Center for Children
Minneapolis, MN 55404
Phone (612) 871-1454
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17533 | MN | MD | Otolaryngology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377734400000",
"number": "1992139661",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2430 NICOLLET AVE SOUTH",
"address_2": "WASHBURN CENTER FOR CHILDREN",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55404",
"telephone_number": "612-871-1454",
"fax_number": "612-871-1505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2430 NICOLLET AVE SOUTH",
"address_2": "WASHBURN CENTER FOR CHILDREN",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "55404",
"telephone_number": "612-871-1454",
"fax_number": "612-871-1505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GALE",
"first_name": "LACEY",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-29",
"last_updated": "2013-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "17533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.