Individual provider Active NPI

Daniel Paul Grinberg, LMSW, LCSW

  • Social Worker
  • Avon, IN
National Provider Identifier
1366960361
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801107398 Issued in MI
Practice address
6655 E US Highway 36
Avon, IN 46123-8923
Phone
(888) 714-1927
Fax
(317) 745-9565
NPI assigned
Aug 30, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 99081384A IN
Clinical Social Worker 1041C0700X 34008658A IN
Social Worker 104100000X 6801107398 MI Primary

Addresses

Primary practice location

6655 E US Highway 36
Avon, IN 46123-8923

Mailing address

5101 E US Highway 36 Ste 100
Avon, IN 46123-6646
Phone (888) 714-1927

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20200908001036 MI Practitioner - Clinical Social Worker 1557693694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Michigan Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Richard Kneip PHD PCGroup PAC ID 4880768415, 243 clinicians

Practice addresses (Care Compare)

41700 Gardenbrook Rd
Suite 110
Novi, MI 48375-1320
Phone (800) 693-1916

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
99081384AINMDSocial Worker
6801107398MIMDSocial Worker
34008658AINMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Richard Kneip, PH.D., P.C. CurrentSince Aug 11, 2020 Accepting new patients

Locations

6548 Town Center Dr
Ste D
Clarkston, MI 48346
Phone (248) 212-8739

41700 Gardenbrook Rd
Ste 110
Novi, MI 48375
Phone (248) 429-7309

89 W South Blvd
Ste 200
Troy, MI 48085
Phone (248) 813-8840

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1504051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1366960361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5101 E US HIGHWAY 36 STE 100",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461236646",
            "telephone_number": "888-714-1927",
            "fax_number": "317-745-9565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6655 E US HIGHWAY 36",
            "city": "AVON",
            "state": "IN",
            "postal_code": "461238923",
            "telephone_number": "888-714-1927",
            "fax_number": "317-745-9565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINBERG",
        "first_name": "DANIEL",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "LMSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-30",
        "last_updated": "2022-07-21",
        "certification_date": "2020-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "IN",
            "license": "99081384A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34008658A",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801107398",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon, IN

Sources for this page

Verify at the official NPI Registry.