MS. GWENDOLYN PETTWAY (NPI# 1932492485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932492485 |
| Entity Type | Individual |
| Full Name | MS. GWENDOLYN PETTWAY |
| Credential | LLPC |
| Practice Address |
559 W Grand Blvd Detroit MI 48216-2200 |
| Practice Telephone | 3135541095 |
| Practice Fax Number | 3137330341 |
| Mailing Telephone | 3135541095 |
| Mailing Fax Number | 3137330341 |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2011-05-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YM0800X |
Counselor Specialization: Mental Health |
64010062571 | MI | Behavioral Health & Social Service Providers |
| Street Address |
559 W GRAND BLVD |
| City | DETROIT |
| State | MI |
| Zip Code | 48216-2200 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528032174 | Scott P Stryd | Family Medicine | 559 W Grand Blvd, Detroit, MI 48216-2200 | 2006-02-13 |
| 1205468154 | Sarah Abbas | Student in an Organized Health Care Education/Training Program | 559 W Grand Blvd, Detroit, MI 48216-2200 | 2020-02-09 |
| 1205134772 | Terri Fata | Dental Hygienist | 559 W Grand Blvd, Detroit, MI 48216-2200 | 2011-03-08 |
| 1003114471 | Fabiola Zamudio | Dental Hygienist | 559 W Grand Blvd, Detroit, MI 48216-2200 | 2011-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285287912 | Karah Jeannine Adams | Social Worker | 1600 Porter Street, Detroit, MI 48216 | 2019-07-22 |
| 1457865354 | Aaa Home Visiting Pllc | Internal Medicine | 1502 Fort St, Detroit, MI 48216 | 2017-11-30 |
| 1083004147 | Dan Webster Christian Wood | Social Worker | 1600 Porter St., Detroit, MI 48216 | 2015-01-28 |
| 1497010938 | Turner's Diagnostics | Clinic/Center | 727 West Grand Boulevard #315, Detroit, MI 48216 | 2012-07-11 |
| 1215177019 | Detroit Medical Centre | General Acute Care Hospital | 5000 Heather Drive, Dearborn, MI 48216 | 2009-03-06 |
| 1619164324 | Celso Enterprise Inc | Clinic/Center | 3968 E Vernor Hwy, Detroit, MI 48216 | 2007-09-26 |
| 1376706069 | Sandra Overstreet-ware | Social Worker | 3815 W Fort St, Detroit, MI 48216 | 2008-07-03 |
| 1013156660 | Carmetta Sharlena Jones | Home Health | 790 W Grand Blvd, Detroit, MI 48216-1003 | 2009-02-05 |
| 1982085429 | Gayle England | Custodial Care Facility | 777 W Grand Blvd, Detroit, MI 48216-1056 | 2015-06-10 |
| 1851734297 | Vishnu Kodumuru | Physical Therapist | 815 W Grand Blvd, Detroit, MI 48216-1056 | 2013-04-16 |
| Find all providers in zip 48216 | ||||
| Taxonomy Code | 101YM0800X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407457799 | Next Level Counseling and Consulting, LLC | Counselor | 5231 Grayton St, Detroit, MI 48224-2149 | 2020-11-04 |
| 1669071585 | Carraus Harden | Counselor | 13238 N Norfolk, Detroit, MI 48235-1026 | 2020-10-21 |
| 1386255032 | Restore Me, LLC | Counselor | 17836 Chandler Park Dr, Detroit, MI 48224-1340 | 2020-08-14 |
| 1396374617 | Venus D Amos | Counselor | 22725 Cambridge Ave, Detroit, MI 48219-1725 | 2020-04-07 |
| 1487280848 | A Safe Place Counseling and Community Support Services L3c | Counselor | 20216 Albany St, Detroit, MI 48234-2505 | 2020-03-18 |
| 1689211088 | Tracey Johnson | Counselor | 14010 Monica St Apt 23, Detroit, MI 48238-2565 | 2019-12-04 |
| 1790320331 | Faith Hope & Love Outreach Center Inc | Counselor | 18284 James Couzens Fwy., Detroit, MI 48235-2503 | 2019-11-07 |
| 1518517606 | Southwest Solutions | Counselor | 5716 Michigan, Detroit, MI 48210 | 2019-09-19 |
| 1942858550 | Ronald Royce Cochran | Counselor | 2925 Russell St, Detroit, Detroit, MI 48207 | 2019-08-27 |
| 1497210744 | Phoenix Interventions Pllc | Counselor | 7633 E Jefferson Ave Ste 110, Detroit, MI 48214-3730 | 2019-01-31 |
| Find all providers in DETROIT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.