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NPI Code Detail

MEDICARE: KATHERINE MCGARVEY GUTE MSW, LCSW, ACSW

MEDICARE: KATHERINE MCGARVEY GUTE MSW, LCSW, ACSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker6801060469MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MIS 242635000OTHERMIMAGELLAN ID
299943OTHERMIBLUE CARE NETWORK ID
38008925560OTHERBLUE CROSS/BLUE SHIELD ID

General Provider Information

NPI Number : 1922100791
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE MCGARVEY GUTE MSW, LCSW, ACSW
Provider Business Mailing Address
First Line : 1311 TIMBERCREEK DR
Second Line :
City : GRAND LEDGE
State : MI
Zip : 48837-2322
Country : US
Telephone Number : 517-622-4448
Fax Number :
Provider Business Practice Location Address
First Line : 311 HARRISON ST
Second Line :
City : GRAND LEDGE
State : MI
Zip : 48837-1577
Country : US
Telephone Number : 517-927-3382
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2006
Last Update Date : 07/19/2011

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