Individual provider Active NPI

John Carmelo Gramuglia, LICSW

  • Clinical Social Worker
  • Colebrook, NH
National Provider Identifier
1205972874
Registry record updated Dec 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1196 Issued in NH
Practice address
4 Titus Hill Rd
Colebrook, NH 03576
Phone
(603) 237-8848
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2009

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1342 MA
Addiction (Substance Use Disorder) Counselor 101YA0400X 0507 NH
Clinical Social Worker 1041C0700X 111585 MA
Clinical Social Worker 1041C0700X 1196 NH Primary
Clinical Social Worker 1041C0700X 089-0000983 VT
Clinical Social Worker 1041C0700X SL 50367 NJ

Addresses

Primary practice location

4 Titus Hill Rd
Colebrook, NH 03576

Mailing address

PO Box 250
Colebrook, NH 03576-0250
Phone (603) 237-4678

Other identifiers 1

IdentifierTypeStateIssuer
304276609MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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

Enrollment IDStateProvider typePAC IDDetails
I20190531001262 NH Practitioner - Clinical Social Worker 8527093103 Practice locations: Plymouth, NH

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1342MAMDAddiction (Substance Use Disorder) Counselor
111585MAMDClinical Social Worker
SL 50367NJMDClinical Social Worker
089-0000983VTMDClinical Social Worker
0507NHMDOccupational Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262217600000",
    "number": "1205972874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 250",
            "city": "COLEBROOK",
            "state": "NH",
            "postal_code": "035760250",
            "telephone_number": "603-237-4678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 TITUS HILL RD",
            "city": "COLEBROOK",
            "state": "NH",
            "postal_code": "03576",
            "telephone_number": "603-237-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMUGLIA",
        "first_name": "JOHN",
        "middle_name": "CARMELO",
        "name_prefix": "Mr.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2009-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "1342",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NH",
            "license": "0507",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "111585",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NH",
            "license": "1196",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "089-0000983",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "SL 50367",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "304276609",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colebrook, NH

Sources for this page

Verify at the official NPI Registry.