Active NPI
Taylor S Groneck, PSYD
- Clinical Psychologist
- Wilmington, OH
National Provider Identifier
1407159098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6747
- Practice address
- 925 S South St
Wilmington, OH 45177-2921 - Phone
- (859) 992-1615
- Fax
- (859) 359-5406
- NPI assigned
- Dec 21, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 Psychologist | 103TC0700X | 6747 | OH | Primary |
Addresses
Primary practice location
925 S South St
Wilmington, OH 45177-2921
Mailing address
925 S South St
Wilmington, OH 45177-2921
Phone (859) 992-1615
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 |
|---|---|---|---|
| 6747 | OH | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1292889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1393718400000",
"number": "1407159098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "925 S SOUTH ST",
"city": "WILMINGTON",
"state": "OH",
"postal_code": "451772921",
"telephone_number": "859-992-1615",
"fax_number": "859-359-5406"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "925 S SOUTH ST",
"city": "WILMINGTON",
"state": "OH",
"postal_code": "451772921",
"telephone_number": "859-992-1615",
"fax_number": "859-359-5406"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRONECK",
"first_name": "TAYLOR",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-12-21",
"last_updated": "2014-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "6747",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.