Gretchen S Gendreau, PSYD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY60968000 Issued in WA

Practice address

426 N Meridian
Puyallup, WA 98371-8636

Phone

(253) 256-6594

NPI assigned

Mar 18, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

PsychiatryAlso: Geriatric Psychiatry

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeast Georgia Psychological Services LLCGroup PAC ID 1850600891, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Northeast Georgia Psychological Services LLC

  • Clinical Psychologist
  • Hoschton, GA
  • NPI 1407230410
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707350400000",
    "number": "1891254058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2205 43RD ST SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983724280",
            "telephone_number": "253-218-9912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "426 N MERIDIAN",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983718636",
            "telephone_number": "253-256-6594"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GENDREAU",
        "first_name": "GRETCHEN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2024-02-08",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "WA",
            "license": "PY60968000",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "MHCA.MC.60930549",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "WA",
            "license": "PY60968000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick C Gaurano
• Laura A Gbadebo
• Katrina Angela Ejes Gearhart
• James E Gee, PA-C
• Adam Clayton Geer
• Blake Patrick Gendron, M.D.
• Genesis Chiropractic Rehabilitation NW Inc
• Nadira Genis, LMP
• Genoa Healthcare, LLC
• Katelyn Rae Genova, PA-C

• Psychologist in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.