Individual provider Active NPI

Gwenette Maurell James, LISW-S

  • Social Worker
  • Wickliffe, OH
National Provider Identifier
1396933115
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
S28637 Issued in OH
Practice address
29339 Euclid Ave Ste 102
Wickliffe, OH 44092-1985
Phone
(216) 799-7559
NPI assigned
Oct 5, 2007
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X S28637 OH Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170117001608 OH Practitioner - Clinical Social Worker 9436431095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
S28637OHMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Commitment to Hope Mental Health Counseling Center LLC Social Worker CurrentSince Jun 11, 2013 Accepting new patients
A Commitment to Love You Inc. Current Accepting new patients
Commitment to Home LLC Past Accepting new patients
Commitment to Hope LLC Past Accepting new patients
Commitment to Hope Mental Health Counseling Center LLC Social Worker Past Accepting new patients

Locations

30799 Pinetree Rd
Pepper Pike, OH 44124
Phone (216) 702-7519

1460 Rockefeller Rd
Wickliffe, OH 44092
Phone (440) 379-1884

1460 Rockefeller Rd
#A
Wickliffe, OH 44092

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1396933115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30799 PINETREE RD # 240",
            "city": "PEPPER PIKE",
            "state": "OH",
            "postal_code": "441245903",
            "telephone_number": "216-799-7559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29339 EUCLID AVE STE 102",
            "city": "WICKLIFFE",
            "state": "OH",
            "postal_code": "440921985",
            "telephone_number": "216-799-7559"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6804 Lansing Ave",
            "address_purpose": "LOCATION",
            "city": "Cleveland",
            "state": "OH",
            "postal_code": "441053757",
            "country_code": "US",
            "telephone_number": "216-641-8820 x228",
            "fax_number": "216-641-8830",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JAMES",
        "first_name": "GWENETTE",
        "middle_name": "MAURELL",
        "name_prefix": "Mrs.",
        "credential": "LISW-S",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "S28637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wickliffe, OH

Sources for this page

Verify at the official NPI Registry.