Active NPI
Erinn Dawn Grassow Grist
- School Social Worker
- Brockton, MA
National Provider Identifier
1396097796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- License
- 330215
- Practice address
- 1115 W Chestnut St
Brockton, MA 02301-7501 - Phone
- (508) 791-4976
- NPI assigned
- Oct 9, 2012
- Last updated
- Oct 9, 2012
- 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 |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | 330215 | MA | Primary |
Addresses
Primary practice location
1115 W Chestnut St
Brockton, MA 02301-7501
Mailing address
172 Dean St
Unit 3
Taunton, MA 02780-2783
Phone (774) 265-5555
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
| License | State | Type | Specialty |
|---|---|---|---|
| 330215 | MA | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349740800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349740800000",
"number": "1396097796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "172 DEAN ST",
"address_2": "UNIT 3",
"city": "TAUNTON",
"state": "MA",
"postal_code": "027802783",
"telephone_number": "774-265-5555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1115 W CHESTNUT ST",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023017501",
"telephone_number": "508-791-4976"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRASSOW GRIST",
"first_name": "ERINN",
"middle_name": "DAWN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-10-09",
"last_updated": "2012-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "MA",
"license": "330215",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.