Mary Bernadette Rose Gonzalez, LMSW
Individual provider Active NPI Clinical Social Worker · Mount Clemens, MI
NPI 1982033320 · NPPES record last updated Apr 19, 2022
Key facts
- NPI
- 1982033320
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 6801114429 (MI)
- Practice address
- 100 NB Gratiot Ave Apt 101
Mount Clemens, MI 48043-2301 - Phone
- (586) 783-2950
- Fax
- (586) 690-4333
- NPI assigned
- Nov 6, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Wayne State University School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Renewal Christian Counseling Inc
County of Macomb
Practice addresses (Care Compare)
100 Northbound Gratiot Ave
Suite a
Mount Clemens, MI 48043-2339
Phone (586) 783-2950
43740 N Groesbeck Hwy
Clinton Township, MI 48036-1139
Phone (586) 469-7229
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220420001223 | MI | Practitioner - Clinical Social Worker | 9830586973 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801095827 | MI | MD | Clinical Social Worker |
| L2527655 | MI | MD | Case Manager/Care Coordinator |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| County of Macomb | Current |
Accepting new patients | |
| County of Macomb | Current |
Accepting new patients | |
| Renewal Christian Counseling Inc | Clinical | Current |
Accepting new patients |
| Renewal Christian Counseling Inc | Clinical | Past | Accepting new patients |
Locations
19800 Hall Rd
Clinton Twp, MI 48038
Phone (586) 854-4804
43740 N Groesbeck Hwy
Clinton Twp, MI 48036
Phone (586) 469-7229
100 Northbound Gratiot Ave
Mount Clemens, MI 48043
Phone (586) 783-2950
100 Northbound Gratiot Ave
Ste A
Mount Clemens, MI 48043
Phone (586) 783-2950
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801095827 | MI | |
| Case Manager/Care Coordinator | 171M00000X | L2527655 | MI | |
| Clinical Social Worker | 1041C0700X | 6801114429 | MI | Yes |
Addresses
Primary practice location
100 NB Gratiot Ave Apt 101
Mount Clemens, MI 48043-2301
Mailing address
100 NB Gratiot Ave Apt 101
Mount Clemens, MI 48043-2301
Phone (586) 783-2950
Other providers in Mount Clemens, MI
- Micaela Anne Gleason
- GLPS Staffing Solutions LLC
- Belinda Golder
- Sydni Alexis Golfin
- Diego Andres Gomez Murphy
- Jennifer Goodin
- Lyndon M Graham
- Nakya Kai Graham
- Thomas C Gratch
- Evan Robert Papa Gray
All providers in Mount Clemens, MI · Clinical Social Worker in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 19, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.