Active NPI
Gwendolyn Gunn-Roberts
- Social Worker
- Clinton Township, MI
National Provider Identifier
1770727612
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6802064973
- Practice address
- 16200 19 Mile Rd
Clinton Township, MI 48038-1103 - Phone
- (586) 243-9164
- Fax
- (586) 416-6333
- NPI assigned
- Apr 22, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6802064973 | MI | Primary |
Addresses
Primary practice location
16200 19 Mile Rd
Clinton Township, MI 48038-1103
Mailing address
75 Rathbone St
Mount Clemens, MI 48043-5957
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6802064973 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240358400000",
"number": "1770727612",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 RATHBONE ST",
"city": "MOUNT CLEMENS",
"state": "MI",
"postal_code": "480435957"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16200 19 MILE RD",
"city": "CLINTON TOWNSHIP",
"state": "MI",
"postal_code": "480381103",
"telephone_number": "586-243-9164",
"fax_number": "586-416-6333"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GUNN-ROBERTS",
"first_name": "GWENDOLYN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-22",
"last_updated": "2009-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6802064973",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton Township, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 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.