GWEN MARIE MILLAM (NPI# 1518162254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518162254 |
| Entity Type | Individual |
| Full Name | GWEN MARIE MILLAM |
| Credential | LICSW |
| Practice Address |
11812 Wayzata Blvd Suite 212 Minnetonka MN 55305-2012 |
| Mailing Address |
3940 Drew Ave S Minneapolis MN 55410-1048 |
| Practice Telephone | 6122515795 |
| Mailing Telephone | 6122515795 |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1041C0700X |
Social Worker Specialization: Clinical |
16697 | MN | Behavioral Health & Social Service Providers |
| Street Address |
11812 WAYZATA BLVD SUITE 212 |
| City | MINNETONKA |
| State | MN |
| Zip Code | 55305-2012 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548370190 | Johanna Lee Lamm | Psychologist | 11812 Wayzata Blvd, Suite 212, Minnetonka, MN 55305-2012 | 2006-08-30 |
| 1629449939 | Traverse Counseling & Consulting | Counselor | 11812 Wayzata Blvd, Minnetonka, MN 55305 | 2015-10-13 |
| 1992058143 | Gail Yost | Marriage & Family Therapist | 11812 Wayzata Blvd, Suite 120, Minnetonka, MN 55305-2012 | 2012-10-24 |
| 1538466784 | Kenneth L Stewart, Phd, Ltd | Psychologist | 11812 Wayzata Blvd, Suite 120, Minnetonka, MN 55305-2012 | 2011-02-24 |
| 1912238684 | Phoenix Process Consultants | Clinic/Center | 11812 Wayzata Blvd, Minnetonka, MN 55305-2012 | 2010-01-20 |
| 1134450083 | Michael Robert Borowiak | Social Worker | 11812 Wayzata Blvd, Suite 100, Minnetonka, MN 55305-2012 | 2010-01-15 |
| 1508039314 | Sean Michael Reardon | Psychologist | 11812 Wayzata Blvd, Suite 100, Minnetonka, MN 55305-2012 | 2008-04-12 |
| 1619148814 | Danette Lynn Jones | Social Worker | 11812 Wayzata Blvd, Suite 100, Minnetonka, MN 55305-2012 | 2008-03-14 |
| 1205934676 | Barbara Sue Goodman-fischtrom | Social Worker | 11812 Wayzata Blvd, Suite # 120, Minnetonka, MN 55305-2012 | 2006-09-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255948584 | Sober Living Connection | Substance Abuse Rehabilitation Facility | 11115 Minnetonka Blvd, Hopkins, MN 55305 | 2020-09-30 |
| 1649739103 | Gabriel Douglas Orem | Occupational Therapist | 10653 Waysata Blvd., Suite 200, Minnetonka, MN 55305 | 2019-03-14 |
| 1750863106 | Andrea Haglin | Counselor | 10505 Wayzata Blvd. Ste 101, Minnetonka, MN 55305 | 2018-09-02 |
| 1770934499 | Acme Transportation | Private Vehicle | 11356 Cedar Pointe Dr, Minnetonka, MN 55305 | 2016-06-23 |
| 1841641743 | Laine Cecily Hartwell Epp | Counselor | 1300 Wayzata Blvd., Ste. 400, Minnetonka, MN 55305 | 2016-06-22 |
| 1407217367 | Larissa Vados | Acupuncturist | 11654 Wayzata Blvd, Minnetonka, MN 55305 | 2016-03-18 |
| 1548658982 | Irene Grudsky | Contractor | 10550 Wayzata Blvd, Minnetonka, MN 55305 | 2015-01-08 |
| 1780093500 | Lalaine Arbuthnot Ortlieb | Counselor | 11900 Wayzata Blvd, Suite 100, Minnetonka, MN 55305 | 2014-08-06 |
| 1235472275 | Katherine Thistle Rivard | Dietitian, Registered | 11240 Cedar Pointe Drive North, Minnetonka, MN 55305 | 2013-03-28 |
| 1558633784 | Vickie Lynn Schaefer | Social Worker | 10505 Wayzata Blve Suite 101, Minnetonka, MN 55305 | 2012-02-03 |
| Find all providers in zip 55305 | ||||
| Taxonomy Code | 1041C0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| Specialization | Clinical |
| A social worker who holds a master’s or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master’s supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. |
| Notes: Source: National Association of Social Workers, 2008 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609423755 | Kathleen Sprole Licsw, LLC | Social Worker | 10501 Wayzata Blvd Ste 204, Minnetonka, MN 55305-1519 | 2019-08-23 |
| 1174007926 | Nancy J Seldin Van Der Voorn | Social Worker | 4838 Woodridge Ct, Minnetonka, MN 55345-3935 | 2018-09-18 |
| 1639536113 | Daniel Neumann | Social Worker | 15665 Woodgate Rd S, Minnetonka, MN 55345-4538 | 2016-01-28 |
| 1437419397 | Tikvah Counseling LLC | Social Worker | 14024 Royal Ct, Minnetonka, MN 55345-3928 | 2012-05-24 |
| 1851651046 | Windows On The World Therapy Services, LLC | Social Worker | 12700 Sherwood Pl, 107, Minnetonka, MN 55305-2449 | 2012-05-21 |
| 1417223371 | Kelly M Nelson | Social Worker | 11708 Wayzata Blvd, Minnetonka, MN 55305-2014 | 2012-03-26 |
| 1558633784 | Vickie Lynn Schaefer | Social Worker | 10505 Wayzata Blve Suite 101, Minnetonka, MN 55305 | 2012-02-03 |
| 1942531009 | Susan Mae Keith | Social Worker | 12601 Ridgedale Dr, Minnetonka, MN 55305-1908 | 2010-01-28 |
| 1306975206 | Marsha Kay Molinari | Social Worker | 11900 Wayzata Blvd., Suite #116g, Minnetonka, MN 55305 | 2007-03-05 |
| 1154485399 | Warren O Watson | Social Worker | 15320 Minnetonka Blvd, #200, Minnetonka, MN 55345 | 2006-12-21 |
| Find all providers in MINNETONKA | ||||
| City | MINNETONKA |
| Zip Code | 55305 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.