Gwendolyn Green (NPI# 1922020916, PAC ID# 6507850328) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is CLINICAL SOCIAL WORKER.
| Nation Provider ID (NPI) | 1922020916 |
| PAC ID by PECOS | 6507850328 |
| Professional Enrollment ID | I20060814000570 |
| Full Name | Gwendolyn Green |
| Organization Legal Name | MICHAEL LEE SEARCY COMMUNITY AND DEVELOPMENT CENTER |
| Address |
11825 Dexter Ave Detroit MI 48206-1007 |
| Phone Number | 3135863033 |
| Gender | F |
| Graduation Year | 1977 |
| Primary Specialty | CLINICAL SOCIAL WORKER |
| Group Practice PAC ID | 1153649645 |
| Number of Group Practice Members | 2 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 11825 Dexter Ave, Detroit, MI 48206-1007 | 3135863033 | MICHAEL LEE SEARCY COMMUNITY AND DEVELOPMENT CENTER |
| Organization Legal Name | MICHAEL LEE SEARCY COMMUNITY AND DEVELOPMENT CENTER |
| Physicians | 4 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shealah Treece | Clinical Social Worker | Michael Lee Searcy Community and Development Center | 3131 Arndt St, Detroit, MI 48207-3247 |
| Zelda R Williams | Clinical Social Worker | Michael Lee Searcy Community and Development Center | 11825 Dexter Ave, Detroit, MI 48206-1007 |
| Rita R Clark | Clinical Social Worker | Michael Lee Searcy Community and Development Center | 11825 Dexter Ave, Detroit, MI 48206-1007 |
| Street Address |
11825 DEXTER AVE |
| City | DETROIT |
| State | MI |
| Zip | 48206-1007 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Zelda R Williams | Clinical Social Worker | Michael Lee Searcy Community and Development Center | 11825 Dexter Ave, Detroit, MI 48206-1007 |
| Rita R Clark | Clinical Social Worker | Michael Lee Searcy Community and Development Center | 11825 Dexter Ave, Detroit, MI 48206-1007 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Saiyid Mohammed Hussaini | Physical Therapy | Reflex Therapeutic Services LLC | 1640 Webb St, Detroit, MI 48206-1350 |
| Angela L Roman | Nurse Practitioner | 9600 Dexter Ave, Detroit, MI 48206-1816 |
| City | DETROIT |
| Zip Code | 48206 |
| Specialty | CLINICAL SOCIAL WORKER |
| City + Specialty | DETROIT + CLINICAL SOCIAL WORKER |
Please comment or provide details below to improve the information on Gwendolyn Green.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.