Individual provider Active NPI

Nicole Grabow, LLMSW

  • Clinical Social Worker
  • Davisburg, MI
National Provider Identifier
1255562765
Registry record updated Jul 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801090630 Issued in MI
Practice address
12850 Fountain SQ
Davisburg, MI 48350-2552
Phone
(248) 634-6303
NPI assigned
Jul 31, 2009
Last updated
Jul 31, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2009

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 6801090630 MI Primary

Addresses

Primary practice location

12850 Fountain SQ
Davisburg, MI 48350-2552

Mailing address

12850 Fountain SQ
Davisburg, MI 48350-2552

Other identifiers 1

IdentifierTypeStateIssuer
750910402OtherMIBLUE CROSS

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
6801090630MIMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1248998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248998400000",
    "number": "1255562765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12850 FOUNTAIN SQ",
            "city": "DAVISBURG",
            "state": "MI",
            "postal_code": "483502552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12850 FOUNTAIN SQ",
            "city": "DAVISBURG",
            "state": "MI",
            "postal_code": "483502552",
            "telephone_number": "248-634-6303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRABOW",
        "first_name": "NICOLE",
        "credential": "LLMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-31",
        "last_updated": "2009-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801090630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "750910402",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davisburg, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2009; 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.