Gwendolyn Williamson, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801079449 Issued in MI

Practice address

1125 E Milham Ave Ste B
Portage, MI 49002-3096

Phone

(269) 312-1446

NPI assigned

Mar 29, 2009

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 names 1

• Wendy Williamson Other name

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1238284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590710400000",
    "number": "1639311202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4337 E GRAND RIVER AVE",
            "address_2": "# 147",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488436583",
            "telephone_number": "248-379-6975",
            "fax_number": "248-319-1143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 E MILHAM AVE STE B",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490023096",
            "telephone_number": "269-312-1446"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4337 E Grand River Ave",
            "address_2": "#147",
            "address_purpose": "LOCATION",
            "city": "Howell",
            "state": "MI",
            "postal_code": "488436583",
            "country_code": "US",
            "telephone_number": "248-379-6975",
            "fax_number": "248-319-1143",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMSON",
        "first_name": "GWENDOLYN",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-29",
        "last_updated": "2020-05-29",
        "certification_date": "2020-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801079449",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WENDY",
            "last_name": "WILLIAMSON",
            "credential": "LMSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Judith McLaurin Williams, LMSW
• Latieca Williams, LMSW
• Lauren Williams
• Marisa Sue Williams, LLMSW-C
• Timothy V Williams, DDS
• Aaron Anthony Willson, D.D.S.
• David M. Wilson, DMD, MD
• Dianne Marie Wilson, BHU-HS
• Rebecca Wilson, MS, LPC
• Abeni Wimbush

• Clinical Social Worker in Portage, MI
• Providers in Portage, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.