Gwendolyn Watts Johnson | Owings Mills, MD • PECOS Search

Gwendolyn Watts Johnson

Social Worker

Behavioral Health & Social Service Providers

9199 Reisterstown Road, Suite 214c, Owings Mills, MD 21117

PECOS Enrollment

Based on the most recent information from CMS, provider Gwendolyn Watts Johnson does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 10:04 AM.

Profile Details

Provider ID
1730253014
Provider Type
Individual
Full Name
Johnson, Gwendolyn Watts
Title
Mrs.
Credential
LCSWC

Gender
Male
Sole Proprietor
No
Enumeration Date
11/20/2006
Last Updated
7/8/2007

Contact Information

Practice Location

9199 Reisterstown Road, Suite 214c, Owings Mills, MD 21117

(410) 552-0774

Mailing Location

1425 Liberty Road, Suite 208, Eldersburg, MD 21784

(410) 552-0774

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 04393 Maryland