Benjamin Jared Grossnickle, LCSW-A, LCAS-A

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C017988 Issued in NC

Practice address

2602 Courtier Dr
Greenville, NC 27834-7818

Phone

(252) 752-0483

Fax

(252) 757-3172

NPI assigned

Jun 12, 2024

Last updated

Jan 30, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Easter Seals Ucp North Carolina and Virginia, Inc.Group PAC ID 7618161407, 49 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Easter Seals Ucp North Carolina & Virginia, Inc.

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1306167713
  Medicare reassignment Care Compare group NPD
• Easter Seals Ucp North Carolina & Virginia, Inc.

  • Pharmacy
  • New Bern, NC
  • NPI 1013769629
  NPD
• Easter Seals Ucp North Carolina & Virginia, Inc.

  • Community/Behavioral Health Agency
  • Greenville, NC
  • NPI 1770335382
  NPD

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

{
    "created_epoch": "1718150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738195200000",
    "number": "1124860705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2602 COURTIER DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347818",
            "telephone_number": "252-752-0483",
            "fax_number": "252-757-3172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 COURTIER DR",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "278347818",
            "telephone_number": "252-752-0483",
            "fax_number": "252-757-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSNICKLE",
        "first_name": "BENJAMIN",
        "middle_name": "JARED",
        "credential": "LCSW-A, LCAS-A",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-12",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-29816",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C017988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savannah Leigh Gronowski, PTA
• Ian Wallace Grooms, DO
• Teresa Gross, F.N.P.
• Mauro Grossi, MD
• Sara G Grossi, DDS
• Growth Mindset Counseling, PLLC
• Christopher Thomas Grubb, M.D.
• Jamie S Grubey, MD
• Lillian Gruebel
• GTR Health Services LLC

• Clinical Social Worker in Greenville, NC
• Providers in Greenville, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.