Nicole R Grunenwald, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW.09930637 Issued in CO

Practice address

179 S Parkside Dr
Colorado Springs, CO 80910-3130

Phone

(719) 572-6100

NPI assigned

Jul 16, 2024

Last updated

Jul 16, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Diversus Health Inc

  dba Diversus Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colorado Springs, CO
  • NPI 1043260243
  Medicare reassignment NPD
• Diversus Health Inc

  dba Diversus Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colorado Springs, CO
  • NPI 1104281872
  NPD
• Diversus Health Inc

  dba Diversus Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colorado Springs, CO
  • NPI 1295269561
  NPD
• Diversus Health Inc

  dba Diversus Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colorado Springs, CO
  • NPI 1245696350
  NPD (past)
• Diversus Health Inc

  dba Diversus Health Services ATU

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Colorado Springs, CO
  • NPI 1295595882
  NPD (past)
• Diversus Health Inc

  dba Diversus Health Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Colorado Springs, CO
  • NPI 1376188847
  NPD (past)
• Diversus Health Inc

  dba Diversus Health Services

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Colorado Springs, CO
  • NPI 1528603008
  NPD (past)
• Diversus Health Inc

  dba Diversus Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Woodland Park, CO
  • NPI 1811352586
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1093553000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1795 JET WING DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809162332",
            "telephone_number": "719-572-6100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 S PARKSIDE DR",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809103130",
            "telephone_number": "719-572-6100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNENWALD",
        "first_name": "NICOLE",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.09930637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin Elizabeth Grudle, NP-C
• Camryn Brooke Gruidl
• Jordyn Grulkowski
• Jason J Grundhauser, D.C.
• Kendelle Grundhauser
• Meghan Joan Grycza, PA-C
• Gayla Skadden Grzegorczyk, MA, CCC-SLP
• Cody Grzybowski, DDS
• Angustia Guambana, CARE PROVIDER
• Gloria Guan, D.D.S.

• Clinical Social Worker in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.