Susan Rose Gran, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

23873 Issued in MN

Practice address

502 E 2ND St
Duluth, MN 55805-1913

Phone

(218) 722-4379

Fax

(218) 722-4333

NPI assigned

Jun 26, 2013

Sex

Female

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)

Enrolled

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1669812319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 E 3RD ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051951",
            "telephone_number": "218-786-8364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 E 2ND ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558051913",
            "telephone_number": "218-722-4379",
            "fax_number": "218-722-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAN",
        "first_name": "SUSAN",
        "middle_name": "ROSE",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-26",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "23873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cheryl L.M Graham, MSW, LICSW
• Lisa S Graham, M.D.
• Allison Grainger
• Rebecca Lynn Grams
• Katelyn Gramstad
• Nicole Granberg
• Grand St Paul CVS LLC
• Grand St Paul CVS LLC
• Anthony Richard Grand, PHARMD
• Emily Rose Grandson, APRN, CNP

• Clinical Social Worker in Duluth, MN
• Providers in Duluth, 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 Nov 23, 2022; 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.