Jordan Gruschow

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC06232800 Issued in NJ

Practice address

550 Emker Ter
Ridgewood, NJ 07450-1202

Phone

(585) 415-3631

NPI assigned

Aug 23, 2023

Sex

Female

Sole proprietor

Yes

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": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1659155307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FOREST AVE STE 201",
            "city": "PARAMUS",
            "state": "NJ",
            "postal_code": "076525246",
            "telephone_number": "201-565-2920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 EMKER TER",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074501202",
            "telephone_number": "585-415-3631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUSCHOW",
        "first_name": "JORDAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "37LC00370900",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06232800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl T Grimm, LCSW
• Jessica Leigh Grimm, DPT
• Andrey Gritsman, M.D.
• Rita Grogan, MD
• Theresa Kathleen Grueter, LCSW
• Lisa Marie Gudicello, M.D.
• Guy Guerriero, D.C.
• Guillermo J. Molina, DDS & Associates, LLC
• Samantha Leigh Guillod, APN
• Sanchita Gupta, M.D., MPH

• Clinical Social Worker in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.