Gretchen Derda Woosley, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C000471 Issued in NC

Practice address

4401 Colwick Rd
Charlotte, NC 28211-2349

Phone

(704) 365-1113

Fax

(704) 365-1757

NPI assigned

Oct 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1160784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225128630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6710 RONDA AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282116125",
            "telephone_number": "704-365-8382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 COLWICK RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282112349",
            "telephone_number": "704-365-1113",
            "fax_number": "704-365-1757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOSLEY",
        "first_name": "GRETCHEN",
        "middle_name": "DERDA",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C000471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD PR",
            "identifier": "141J2",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6002664",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Zeina Naoum Woolhiser
• Thomas Hayes Woollen, M.D.
• Kimberly J Woolley, LCSW
• Amy H Woolwine, MD
• Melissa Brunner Woolworth, MD
• Benjamin Matthew Wooster, MD
• Cyrena Bishop Wooster
• Roshawnda Wooten-White
• Carly Alyse Wooten, PSYD
• Susanna Eleanor Wooten, MSP-CCC,SLP

• Clinical Social Worker in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.