Individual provider Active NPI

Ilene Beth Grunspan, LSCSW, CEAP

  • Clinical Social Worker
  • Leawood, KS
National Provider Identifier
1306177696
Registry record updated Jan 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1880 Issued in KS
Practice address
11111 Nall Ave
Suite 103
Leawood, KS 66211-1924
Phone
(913) 832-0366
Fax
(913) 342-0066
NPI assigned
Jan 26, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 26, 2010

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 1880 KS Primary

Addresses

Primary practice location

11111 Nall Ave
Suite 103
Leawood, KS 66211-1924

Mailing address

12618 Slater St
Overland Park, KS 66213-4721
Phone (913) 832-0366

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
1880KSMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1264464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264464000000",
    "number": "1306177696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12618 SLATER ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662134721",
            "telephone_number": "913-832-0366",
            "fax_number": "913-342-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11111 NALL AVE",
            "address_2": "SUITE 103",
            "city": "LEAWOOD",
            "state": "KS",
            "postal_code": "662111924",
            "telephone_number": "913-832-0366",
            "fax_number": "913-342-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNSPAN",
        "first_name": "ILENE",
        "middle_name": "BETH",
        "credential": "LSCSW, CEAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-26",
        "last_updated": "2010-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "1880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leawood, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2010; 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.