Diane Rae Grinnell, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

8942 Issued in MN

Practice address

3450 Oleary LN
Eagan, MN 55123-2340

Phone

(651) 454-0114

Fax

(651) 454-3492

NPI assigned

Oct 5, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1649366808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12773 ETHELTON WAY",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551247802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 OLEARY LN",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551232340",
            "telephone_number": "651-454-0114",
            "fax_number": "651-454-3492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINNELL",
        "first_name": "DIANE",
        "middle_name": "RAE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-05",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "8942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "60F01GR",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UBH",
            "identifier": "62-60394",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN CARE",
            "identifier": "018757700",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UCARE",
            "identifier": "123136",
            "state": "FM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHPARTNERS",
            "identifier": "HP17977",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BHP",
            "identifier": "41-1546550",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregg M Poquette B.S. D.C. P.a.
• Gregg M Poquette BS DC PA
• Justine Greig
• Alison M Gresback, CPD, LC
• Michelle Griffin, PT
• Tarah Lynn Groettum, MSED, LPCC
• Lisa Gronneberg
• Group Health Plan Inc
• Frank Morris Grund, M.D.
• Adam Guderian

• Clinical Social Worker in Eagan, MN
• Providers in Eagan, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2018; 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.