Active NPI
Gwendolyn Green
- Clinical Social Worker
- Detroit, MI
National Provider Identifier
1922020916
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801007096
- Practice address
- 3131 Arndt St
Detroit, MI 48207-3247 - Phone
- (313) 586-3033
- NPI assigned
- Jul 25, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801007096 | MI | Primary |
Addresses
Primary practice location
3131 Arndt St
Detroit, MI 48207-3247
Mailing address
18875 Hull St
Detroit, MI 48203-2111
Phone (313) 586-3033
Other practice location 1
18212 Wisconsin St
Detroit, MI 48221-2062
Phone (313) 445-0240
Other practice location 2
11825 Dexter Ave
Detroit, MI 48206-1007
Phone (313) 586-3033
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6801007096 | Other | MI | STATE LIC |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Meridian Human Services | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Group Psychotherapy Psychologist
- Southfield, MI
- NPI 1184659773
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1922020916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18875 HULL ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482032111",
"telephone_number": "313-586-3033"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3131 ARNDT ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482073247",
"telephone_number": "313-586-3033"
}
],
"practiceLocations": [
{
"address_1": "18212 Wisconsin St",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482212062",
"country_code": "US",
"telephone_number": "313-445-0240",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "11825 Dexter Ave",
"address_purpose": "LOCATION",
"city": "Detroit",
"state": "MI",
"postal_code": "482061007",
"country_code": "US",
"telephone_number": "313-586-3033",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GREEN",
"first_name": "GWENDOLYN",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-25",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801007096",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LIC",
"identifier": "6801007096",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.