Meribeth Gandy Pezda LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801070819 Issued in MI

Legal business name

MERIBETH GANDY PEZDA LLC

Practice address

959 Baker Rd
Suite 1a
Dexter, MI 48130-1593

Phone

(734) 757-3103

NPI assigned

Oct 26, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Meribeth Gandy Pezda, LMSA

Title

Licensed Clinical Social Worker

Phone

(734) 757-3103

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1477440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477440000000",
    "number": "1982156980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "959 BAKER RD",
            "address_2": "SUITE 1A",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481301593",
            "telephone_number": "734-757-3103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "959 BAKER RD",
            "address_2": "SUITE 1A",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "481301593",
            "telephone_number": "734-757-3103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERIBETH GANDY PEZDA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-26",
        "last_updated": "2016-10-26",
        "status": "A",
        "authorized_official_last_name": "GANDY PEZDA",
        "authorized_official_first_name": "MERIBETH",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "734-757-3103",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LMSA"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801070819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Dexter, MI
• Providers in Dexter, 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 Oct 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.