Individual provider Active NPI

Alissa Gren, LICSW

  • Clinical Social Worker
  • Morgantown, WV
National Provider Identifier
1497128417
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
DP00944107 Issued in WV
Practice address
235 High St Ste 819
Morgantown, WV 26505-5448
Phone
(304) 202-1950
NPI assigned
Nov 13, 2015
Last updated
Nov 25, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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 DP00944107 WV Primary

Addresses

Primary practice location

235 High St Ste 819
Morgantown, WV 26505-5448

Mailing address

235 High St Ste 819
Morgantown, WV 26505-5448
Phone (304) 202-1950

Other practice location 1

7000 Coombs Farm Rd Ste 202
Morgantown, WV 26508-0803
Phone (304) 906-9140

Other practice location 2

930 Chestnut Ridge Rd
Morgantown, WV 26505-2807
Phone (304) 598-4214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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
I20191111002789 WV Practitioner - Clinical Social Worker 2567894678 Practice locations: Morgantown, WV

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DP00944107WVMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1447372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1497128417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 HIGH ST STE 819",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265055448",
            "telephone_number": "304-202-1950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 HIGH ST STE 819",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265055448",
            "telephone_number": "304-202-1950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7000 Coombs Farm Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265080803",
            "country_code": "US",
            "telephone_number": "304-906-9140",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "930 Chestnut Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Morgantown",
            "state": "WV",
            "postal_code": "265052807",
            "country_code": "US",
            "telephone_number": "304-598-4214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GREN",
        "first_name": "ALISSA",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-13",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WV",
            "license": "DP00944107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgantown, WV

Sources for this page

Verify at the official NPI Registry.