Active NPI
Marilyn Kay Gerwolls, PH.D.
- Psychologist
- Dearborn, MI
National Provider Identifier
1275869109
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6301008434
- Practice address
- 7467 Bingham St
Dearborn, MI 48126-1428 - Phone
- (313) 600-9553
- NPI assigned
- Oct 28, 2009
- Last updated
- Oct 28, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6301008434 | MI | Primary |
| Clinical Psychologist | 103TC0700X | 6301008434 | MI | |
| Forensic Psychologist | 103TF0200X | 6301008434 | MI | |
| Health Psychologist | 103TH0004X | 6301008434 | MI |
Addresses
Primary practice location
7467 Bingham St
Dearborn, MI 48126-1428
Mailing address
7467 Bingham St
Dearborn, MI 48126-1428
Phone (313) 600-9553
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)
- Enrolled
- Credentials
- Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Seniors Wellness Group of Michigan, P.C. | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Psychologist
- Royal Oak, MI
- NPI 1801848718
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256688000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256688000000",
"number": "1275869109",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7467 BINGHAM ST",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481261428",
"telephone_number": "313-600-9553"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7467 BINGHAM ST",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481261428",
"telephone_number": "313-600-9553"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GERWOLLS",
"first_name": "MARILYN",
"middle_name": "KAY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-10-28",
"last_updated": "2009-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MI",
"license": "6301008434",
"primary": true
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301008434",
"primary": false
},
{
"code": "103TF0200X",
"taxonomy_group": "",
"desc": "Psychologist, Forensic",
"state": "MI",
"license": "6301008434",
"primary": false
},
{
"code": "103TH0004X",
"taxonomy_group": "",
"desc": "Psychologist, Health",
"state": "MI",
"license": "6301008434",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dearborn, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.