| Gemswithin | |
|
7863 Broadway Ste 115 Merrillville IN 46410-5564 | |
| (219) 779-0509 | |
| Not Available |
| Full Name | Gemswithin |
|---|---|
| Speciality | Social Worker |
| Location | 7863 Broadway Ste 115, Merrillville, Indiana |
| Authorized Official Name and Position | Lynn Mcdonald (CREDENTIALING) |
| Authorized Official Contact | 2197691670 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gemswithin 7863 Broadway Ste 115 Merrillville IN 46410-5564 Ph: (219) 779-0509 | Gemswithin 7863 Broadway Ste 115 Merrillville IN 46410-5564 Ph: (219) 779-0509 |
| NPI Number | 1043804750 |
|---|---|
| Provider Enumeration Date | 02/23/2021 |
| Last Update Date | 03/10/2026 |
| Certification Date | 03/10/2026 |
| Medicare PECOS PAC ID | 5890100986 |
|---|---|
| Medicare Enrollment ID | O20210223002951 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043804750 | NPI | - | NPPES |
| 300046922 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Claude Ann Poupolos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1063828879 PECOS PAC ID: 6507133857 Enrollment ID: I20170517001714 |
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