Individual provider Active NPI

Jessica Grueneich, MSW, LCSW, QMHP

  • Clinical Social Worker
  • Sioux Falls, SD
National Provider Identifier
1548703192
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3596 Issued in SD
Practice address
2000 S Summit Ave
Sioux Falls, SD 57105-2727
Phone
(605) 336-0510
Fax
(605) 336-3779
NPI assigned
Nov 30, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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 3596 SD Primary

Addresses

Primary practice location

2000 S Summit Ave
Sioux Falls, SD 57105-2727

Mailing address

2000 S Summit Ave
Sioux Falls, SD 57105-2727
Phone (605) 336-0510

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3596SDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Solidarity Mental Health LLC Clinical Current Accepting new patients
Southeastern Behavioral Healthcare PastSince Feb 29, 2020 Accepting new patients

Organizations & group practices 2

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": "1480464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1548703192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 S SUMMIT AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571052727",
            "telephone_number": "605-336-0510",
            "fax_number": "605-336-3779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 S SUMMIT AVE",
            "city": "SIOUX FALLS",
            "state": "SD",
            "postal_code": "571052727",
            "telephone_number": "605-336-0510",
            "fax_number": "605-336-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUENEICH",
        "first_name": "JESSICA",
        "credential": "MSW, LCSW, QMHP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-30",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "SD",
            "license": "3596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sioux Falls, SD

Sources for this page

Verify at the official NPI Registry.