Ralph William Groom Jr., LCSW, LBA

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2016004103 Issued in MO

Practice address

3877 Humphrey St
Saint Louis, MO 63116-4825

Phone

(314) 704-0900

NPI assigned

Aug 6, 2012

Last updated

Apr 27, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1344211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1568719953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3877 HUMPHREY ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631164825",
            "telephone_number": "314-704-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3877 HUMPHREY ST",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631164825",
            "telephone_number": "314-704-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROOM",
        "first_name": "RALPH",
        "middle_name": "WILLIAM",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "LCSW, LBA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-06",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2016004103",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "MO",
            "license": "2013028554",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meghan Grojean
• Ryleigh Nicole Grommet, PA-C
• Madeline Marie Grondalski, MD
• Steven J Grondalski, O.D.
• Meredith P Gronski, OT
• Robert J Gropler, MD
• Michelle M Groppe, PTA
• Gretchen Grosch, DO
• Jolene Esther Grosch, PT
• Jackie L Grosklos, MD

• Clinical Social Worker in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.