Individual provider Active NPI

Megan Michelle Gramlow, MSW, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1124485479
Registry record updated May 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
22609 Issued in MN
Practice address
1516 W Lake St Ste 110
Minneapolis, MN 55408-2554
Phone
(701) 238-4355
NPI assigned
Jan 18, 2016
Last updated
May 8, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 22609 MN Primary

Addresses

Primary practice location

1516 W Lake St Ste 110
Minneapolis, MN 55408-2554

Mailing address

2712 Fremont Ave S
Minneapolis, MN 55408-1122
Phone (701) 238-4355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22609MNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1453075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1124485479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2712 FREMONT AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554081122",
            "telephone_number": "701-238-4355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 W LAKE ST STE 110",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554082554",
            "telephone_number": "701-238-4355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMLOW",
        "first_name": "MEGAN",
        "middle_name": "MICHELLE",
        "credential": "MSW, LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-18",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "22609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.