Individual provider Active NPI

Dana Marie Grethen, LICSW

  • Clinical Social Worker
  • Minneapolis, MN
National Provider Identifier
1629337043
Registry record updated May 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
18981 Issued in MN
Practice address
245 Clifton Ave
Minneapolis, MN 55403-3467
Phone
(612) 870-3787
Fax
(612) 870-3789
NPI assigned
May 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2012

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 18981 MN Primary

Addresses

Primary practice location

245 Clifton Ave
Minneapolis, MN 55403-3467

Mailing address

245 Clifton Ave
Minneapolis, MN 55403-3467
Phone (612) 870-3787

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

LicenseStateTypeSpecialty
18981MNMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336089600000",
    "number": "1629337043",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 CLIFTON AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033467",
            "telephone_number": "612-870-3787",
            "fax_number": "612-870-3789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 CLIFTON AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554033467",
            "telephone_number": "612-870-3787",
            "fax_number": "612-870-3789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRETHEN",
        "first_name": "DANA",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-04",
        "last_updated": "2012-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "18981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.

Verify at the official NPI Registry.