Individual provider Active NPI

Donald Leon Grumbine, LCSW

  • Clinical Social Worker
  • New Paltz, NY
National Provider Identifier
1659458495
Registry record updated May 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R020967-1 Issued in NY
Practice address
15 High Ridge Rd
New Paltz, NY 12561-2911
Phone
(845) 255-8830
NPI assigned
Nov 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2015

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 R020967-1 NY Primary

Addresses

Primary practice location

15 High Ridge Rd
New Paltz, NY 12561-2911

Mailing address

15 High Ridge Rd
New Paltz, NY 12561-2911
Phone (845) 255-8830

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.
Opted out of Medicare
Yes, effective Jul 1, 2015 through Jul 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R020967-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431388800000",
    "number": "1659458495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 HIGH RIDGE RD",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125612911",
            "telephone_number": "845-255-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 HIGH RIDGE RD",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125612911",
            "telephone_number": "845-255-8830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUMBINE",
        "first_name": "DONALD",
        "middle_name": "LEON",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2015-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R020967-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Paltz, NY

Sources for this page

Verify at the official NPI Registry.