Individual provider Active NPI

Gregory Bruce Lawrence

  • Clinical Social Worker
  • Detroit, MI
National Provider Identifier
1164659249
Registry record updated Jun 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801089328 Issued in MI
Practice address
404 E Grand Blvd
Detroit, MI 48207-3619
Phone
(313) 478-1537
NPI assigned
Jun 16, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 16, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801089328 MI Primary

Addresses

Primary practice location

404 E Grand Blvd
Detroit, MI 48207-3619

Mailing address

PO Box 40571
Redford, MI 48240-0571
Phone (313) 293-1885

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
New Century Adult Day Program Services, LLC Clinical CurrentSince Oct 5, 2009 Accepting new patients
Kings Special Care Home Inc Clinical CurrentSince Jun 7, 2009 Accepting new patients
Additional Day Care Inc PastSince Jun 7, 2009 Accepting new patients
Casey & Casey Inc Past Accepting new patients
Montgomery Psychological Services, PLLC PastSince Oct 5, 2009 Accepting new patients

Locations

400 S Dort Hwy
Flint, MI 48503
Phone (810) 422-5468

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1164659249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40571",
            "city": "REDFORD",
            "state": "MI",
            "postal_code": "482400571",
            "telephone_number": "313-293-1885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 E GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482073619",
            "telephone_number": "313-478-1537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "GREGORY",
        "middle_name": "BRUCE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-06-16",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801089328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.