Nicole Ray Groschen, MSW LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

24263 Issued in MN

Practice address

2807 Brookdale Dr
Brooklyn Park, MN 55444-1844

Phone

(763) 237-9898

Fax

(763) 503-4820

NPI assigned

Sep 1, 2017

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

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": "1504224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1504224000000",
    "number": "1669990305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13102 288TH ST",
            "city": "LINDSTROM",
            "state": "MN",
            "postal_code": "550457036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2807 BROOKDALE DR",
            "city": "BROOKLYN PARK",
            "state": "MN",
            "postal_code": "554441844",
            "telephone_number": "763-237-9898",
            "fax_number": "763-503-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSCHEN",
        "first_name": "NICOLE",
        "middle_name": "RAY",
        "credential": "MSW LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-01",
        "last_updated": "2017-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "24263",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Brooklyn Park, MN
• Providers in Brooklyn Park, 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 Sep 1, 2017; 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.