MR. GERALD WILLIS (NPI# 1952428286) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952428286 |
| Entity Type | Individual |
| Full Name | MR. GERALD WILLIS |
| Credential | F.S.A.C. |
| Practice Address |
13220 Woodward Ave Highland Park MI 48203-3610 |
| Practice Telephone | 3138521637 |
| Mailing Telephone | 3138521637 |
| Enumeration Date | 2007-03-23 |
| Last Update Date | 2007-07-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
MI | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | CHRISTIAN GUIDANCE CENTER | 1740313238 | 01 |
| MI | 3022440 | 05 |
| Street Address |
13220 WOODWARD AVE |
| City | HIGHLAND PARK |
| State | MI |
| Zip Code | 48203-3610 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740313238 | Detroit Rescue Mission Ministries | Substance Abuse Rehabilitation Facility | 13220 Woodward Ave, Highland Park, MI 48203-3610 | 2007-03-13 |
| 1275652794 | Sylvia Jennings | Licensed Practical Nurse | 13220 Woodward Ave, Highland Park, MI 48203-3610 | 2007-03-28 |
| 1407975758 | Kathy Lynn Parker | Licensed Practical Nurse | 13220 Woodward Ave, Highland Park, MI 48203-3610 | 2007-03-28 |
| 1225156177 | Illene Rita Bosley | Counselor | 13220 Woodward Ave, Highland Park, MI 48203-3610 | 2007-03-27 |
| 1386762185 | Alisa Joy Gordon | Licensed Practical Nurse | 13220 Woodward Ave, Highland Park, MI 48203-3610 | 2007-03-27 |
| 1992824627 | Laketa Yvette Woods | Nurse's Aide | 13220 Woodward Ave, Highland Park, MI 48203-3610 | 2007-03-27 |
| 1376661959 | Conrad Michael Bobb-semple | Counselor | 13220 Woodward Ave, Highland Park, MI 48203-3610 | 2007-03-26 |
| 1437277035 | Janice Smith | Counselor | 13220 Woodward Ave, Highland Park, MI 48203-3610 | 2007-03-26 |
| 1922125806 | Irma Jean Payne | Counselor | 13220 Woodward Ave, Highland Park, MI 48203-3610 | 2007-03-23 |
| 1083731301 | Michael John Mcmullen | Counselor | 13220 Woodward Ave, Highland Park, MI 48203-3610 | 2007-03-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992355135 | James Calloway | Peer Specialist | 1211 E Mcnichols, Detroit, MI 48203 | 2019-09-19 |
| 1851868582 | Community Veterans Services Inc | Counselor | 163 Tennyson, Highland Park, MI 48203 | 2018-10-31 |
| 1346601838 | Rainbow Center of Michigan | Health Maintenance Organization | 12501 Hamilton Ave., Highland Park, MI 48203 | 2016-03-11 |
| 1134502354 | Minds Moving In New Directions Inc | Community/Behavioral Health | 62 Massachusetts St, Highland Park, MI 48203 | 2015-07-07 |
| 1811312937 | Brea Holloway | Home Health | 20249 Yacama Rd, Detroit, MI 48203 | 2014-02-26 |
| 1770821795 | St John Providence Health Systems | Community/Behavioral Health | 1150 Lantz St, Detroit, MI 48203 | 2013-01-25 |
| 1871845412 | Waneta Darcell Dickerson | Social Worker | 169 W. Buena Vista, Highlandpark, MI 48203 | 2012-10-05 |
| 1629331939 | Maureen Connolly | Pediatrics | 77 Victor St, Highland Park, MI 48203 | 2012-06-21 |
| 1578850251 | Detroit Recovery Project | Community/Behavioral Health | 1121 East Mc Nichols, Detroit, MI 48203 | 2011-07-01 |
| 1265728414 | Barbara Suzanne Tyson | Home Health | 301 Glendale St, Apt B8, Highland Park, MI 48203 | 2011-06-27 |
| Find all providers in zip 48203 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811516651 | Tamara Sanderfield | Counselor | 33 Labelle St Apt 610, Highland Park, MI 48203-3687 | 2020-04-12 |
| 1780224725 | Imagine U | Counselor | 62 Massachusetts St # 3, Highland Park, MI 48203-3537 | 2020-01-07 |
| 1962865907 | Timothy C Dennis | Counselor | 1724 1st St., Nicasa, Highland Park, IL 60035 | 2016-03-29 |
| 1821458027 | Sarah Marie Pinger | Counselor | 1724 1st Street, Highland Park, IL 60035 | 2016-03-01 |
| 1033586284 | Shale Marks | Counselor | 210 Skokie Valley Rd Ste A, Highland Park, IL 60035-4464 | 2015-08-24 |
| 1518362276 | Philip M. Zarowny | Counselor | 322 Temple Ave, Highland Park, IL 60035-1427 | 2014-10-23 |
| 1104015494 | William Edward-joseph Johnson | Counselor | 91 Glendale St, Highland Park, MI 48203-3274 | 2007-10-23 |
| 1083747042 | Pamela Elaine Alexander | Counselor | 211 Glendale St, Highland Park, MI 48203-3231 | 2007-03-13 |
| 1740383694 | Sybil Yvette Williams-gray | Counselor | 324 Raritan Ave., Suite 115, Highland Park, NJ 08904-2758 | 2006-09-06 |
| 1427664937 | Armonique Threatt | Counselor | 12501 Hamilton Ave, Highland Park, MI 48203-3243 | 2020-09-21 |
| Find all providers in HIGHLAND PARK | ||||
| City | HIGHLAND PARK |
| Zip Code | 48203 |
Please comment or provide details below to improve the information on MR. GERALD WILLIS.
| 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.