Linda Grunbaum, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R012702-1 Issued in NY

Practice address

310 W End Ave # 12a
New York, NY 10023-8146

Phone

(212) 496-7453

NPI assigned

Jun 22, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• The Bridge, Inc.

  • Community/Behavioral Health Agency
  • New York, NY
  • NPI 1831269315
  NPD (past)

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1255377644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 W END AVE # 12A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100238146",
            "telephone_number": "212-496-7453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W END AVE # 12A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100238146",
            "telephone_number": "212-496-7453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNBAUM",
        "first_name": "LINDA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-22",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R012702-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE  UNSPECIFIED",
            "identifier": "2644132631",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clarissa Antonia Grullon, BA, MA
• Genesis Grullon, RN, NP
• Gissel Grullon, OTR/L
• Lianne Grullon, LMSW
• Willie Grullon
• Alena Lygate Grunberg, LCSW
• Helga Grunberg, PH.D
• Matthew Jake Grundstein
• Dominick Edwin Grundy, PH.D.
• Amos Grunebaum, MD

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2008; 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.