Jacqueline M Grimm, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

12635-123 Issued in WI

Practice address

1615 Maple LN
Ashland, WI 54806-3689

Phone

(715) 685-5373

Fax

(715) 682-0171

NPI assigned

Aug 18, 2020

Sex

Female

Sole proprietor

No

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

Enrolled in WI

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.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Memorial Medical Center Inc

  • Critical Access Hospital
  • Ashland, WI
  • NPI 1437179231
  Medicare reassignment NPD
• Memorial Medical Center Inc

  • Rural Health Clinic/Center
  • Ashland, WI
  • NPI 1770255937
  NPD

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762905600000",
    "number": "1679185029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1615 MAPLE LN",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548063689",
            "telephone_number": "715-685-5373",
            "fax_number": "715-682-0171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 MAPLE LN",
            "city": "ASHLAND",
            "state": "WI",
            "postal_code": "548063689",
            "telephone_number": "715-685-5373",
            "fax_number": "715-682-0171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMM",
        "first_name": "JACQUELINE",
        "middle_name": "M",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2025-11-12",
        "certification_date": "2025-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "12635-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joyce Lynn Goglin, C.N.M
• Victoria Gokee, DDS
• Allissah Gorton, DPT
• Paula Amber Lettie Goyke
• Jill Marie Grehn, LPTA
• Samantha Jo Gronseth, PTA
• Thomas A. Guffy, M.D.
• Lorrie J Guski, COTA
• Holly H Hagstrom, LPC
• Susan M Halbe, FNP

• Clinical Social Worker in Ashland, WI
• Providers in Ashland, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.