Healthcare Provider Details

I. General information

NPI: 1548924533
Provider Name (Legal Business Name): GIL RAYMOND SALGADO LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2021
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

614 S PICKWICK AVE
SPRINGFIELD MO
65802-3339
US

IV. Provider business mailing address

218 S MAIN ST FL 2
JOPLIN MO
64801-2308
US

V. Phone/Fax

Practice location:
  • Phone: 417-413-4774
  • Fax:
Mailing address:
  • Phone: 417-295-7275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2025036763
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number27919-C
License Number StateAR
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number20707
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: