Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Gwen Lotta, LCSW

Individual provider Social Worker · NPI 1053947796

Gwen Lotta, LCSW is a Clinical Social Worker in Grand Forks, North Dakota. Qualified in 2018, 8 years ago. Practices with Peterson Medical Clinics LLC, a 89-clinician group, accepts Medicare assignment and offers telehealth. Licensed in North Dakota and New York.

Years since qualifying
8
Licensed in
ND, NY
In the registry since
2020
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

3674 S Washington St
Grand Forks, ND 58201-5766
Phone: (701) 205-3000
Fax: (701) 732-2501
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 6309 (ND)
Social Worker Taxonomy 104100000X · Licence 096785 (NY)

Record details

NPI number1053947796
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorYes
NPI enumeratedMarch 13, 2020
Last updated in NPPESJuly 15, 2026
Certification dateJuly 15, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Peterson Medical Clinics Llc — 89 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

Other providers in Grand Forks