Healthcare Provider Details

I. General information

NPI: 1396661260
Provider Name (Legal Business Name): SUMMER RAE GILL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 SE 2ND ST
OCALA FL
34471-2326
US

IV. Provider business mailing address

820 SE 2ND ST
OCALA FL
34471-2326
US

V. Phone/Fax

Practice location:
  • Phone: 352-875-8972
  • Fax:
Mailing address:
  • Phone: 352-875-8972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW25820
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: