Active NPI
Gwen Robin Gruber, LCSW
- Clinical Social Worker
- Phoenix, AZ
National Provider Identifier
1285897082
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LCSW 12445
- Practice address
- 4202 N 32ND St
Suite J Trasnformation Institute
Phoenix, AZ 85018 - Phone
- (602) 670-9617
- NPI assigned
- Jul 2, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LCSW 12445 | AZ | Primary |
Addresses
Primary practice location
4202 N 32ND St
Suite J Trasnformation Institute
Phoenix, AZ 85018
Mailing address
15065 N 49TH Way
Scottsdale, AZ 85254
Phone (602) 787-2960
Other names 1
- Gwendolyn Gruber Nardulli
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW 12445 | AZ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214956800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214956800000",
"number": "1285897082",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15065 N 49TH WAY",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "85254",
"telephone_number": "602-787-2960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4202 N 32ND ST",
"address_2": "SUITE J TRASNFORMATION INSTITUTE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85018",
"telephone_number": "602-670-9617"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUBER",
"first_name": "GWEN",
"middle_name": "ROBIN",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-02",
"last_updated": "2008-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "LCSW 12445",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "GWENDOLYN",
"last_name": "GRUBER NARDULLI",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.