MEDICARE: MWG EDUCATOR AND CLINICIAN LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1790525384
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MWG EDUCATOR AND CLINICIAN LLC

Provider Business Mailing Address
First Line	:	6 KILMER RD UNIT A114
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-2432
Country	:	US
Telephone Number	:	908-720-9191
Fax Number	:

Provider Business Practice Location Address
First Line	:	6 KILMER RD UNIT A114
Second Line	:
City	:	EDISON
State	:	NJ
Zip	:	08817-2432
Country	:	US
Telephone Number	:	908-720-9191
Fax Number	:

Authorized Official
Title or Position	:	NP
Name	:	MONA WILLIAMS-GREGORY
Credential	:
Telephone Number	:	908-720-9191

Provider Enumeration Date	:	05/30/2024
Last Update Date	:	03/13/2026

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