Gwenette Maurell James, LISW-S
Individual provider Active NPI Social Worker · Wickliffe, OH
NPI 1396933115 · NPPES record last updated Jul 21, 2022
Key facts
- NPI
- 1396933115
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- S28637 (OH)
- Practice address
- 29339 Euclid Ave Ste 102
Wickliffe, OH 44092-1985 - Phone
- (216) 799-7559
- NPI assigned
- Oct 5, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 5
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1460 Rockefeller Rd
Wickliffe, OH 44092-1932
Phone (440) 799-7559
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170117001608 | OH | Practitioner - Clinical Social Worker | 9436431095 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S28637 | OH | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| A Commitment to Love You Inc. | Current | Accepting new patients | |
| Commitment to Hope Mental Health Counseling Center LLC | Social Worker | Current |
Accepting new patients |
| Commitment to Hope Mental Health Counseling Center LLC | Social Worker | Past | Accepting new patients |
| Commitment to Home LLC | Past | Accepting new patients | |
| Commitment to Hope LLC | Past | Accepting new patients |
Locations
30799 Pinetree Rd
Pepper Pike, OH 44124
Phone (216) 702-7519
1460 Rockefeller Rd
#A
Wickliffe, OH 44092
1460 Rockefeller Rd
Wickliffe, OH 44092
Phone (440) 345-8458
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | S28637 | OH | Yes |
Addresses
Primary practice location
29339 Euclid Ave Ste 102
Wickliffe, OH 44092-1985
Mailing address
30799 Pinetree Rd # 240
Pepper Pike, OH 44124-5903
Phone (216) 799-7559
Other practice location 1
6804 Lansing Ave
Cleveland, OH 44105-3757
Phone (216) 641-8820 ext. 228
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0158309 | Medicaid | OH |
Other providers in Wickliffe, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.