Individual provider Active NPI

Suzanne Reuschlein Gruen, MSSW, LCSW

  • Clinical Social Worker
  • Monona, WI
National Provider Identifier
1235376559
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
7512-123 Issued in WI
Practice address
5900 Monona Dr
Suite 100- Samaritan Counseling Center
Monona, WI 53716-3554
Phone
(608) 663-0763
NPI assigned
Jan 8, 2009
Last updated
Apr 23, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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 7512-123 WI Primary

Addresses

Primary practice location

5900 Monona Dr
Suite 100- Samaritan Counseling Center
Monona, WI 53716-3554

Mailing address

5900 Monona Dr
Suite 100- Samaritan Counseling Center
Monona, WI 53716-3554
Phone (608) 663-0763

Other identifiers 1

IdentifierTypeStateIssuer
1235376559MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20090507000317 WI Practitioner - Clinical Social Worker 9931257623 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Samaritan Counseling Center of Southern Wisconsin IncGroup PAC ID 3870558281, 8 clinicians

Practice addresses (Care Compare)

5900 Monona Dr
Suite 100
Monona, WI 53716-3556
Phone (608) 663-0763

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7512-123WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Samaritan Counseling Center of Southern Wisconsin Inc CurrentSince Apr 22, 2009 Accepting new patients
Samaritan Counseling Center PastSince Apr 22, 2009 Accepting new patients

Locations

5900 Monona Dr
Ste 100
Monona, WI 53716
Phone (608) 663-0763

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1231372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1235376559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 MONONA DR",
            "address_2": "SUITE 100- SAMARITAN COUNSELING CENTER",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537163554",
            "telephone_number": "608-663-0763",
            "fax_number": "608-663-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 MONONA DR",
            "address_2": "SUITE 100- SAMARITAN COUNSELING CENTER",
            "city": "MONONA",
            "state": "WI",
            "postal_code": "537163554",
            "telephone_number": "608-663-0763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUEN",
        "first_name": "SUZANNE",
        "middle_name": "REUSCHLEIN",
        "credential": "MSSW,  LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-08",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "7512-123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235376559",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Monona, WI

Sources for this page

Verify at the official NPI Registry.