Active NPI
Brittney Neuman Neidhardt-Gruhl, LICSW
- Clinical Social Worker
- Renton, WA
National Provider Identifier
1700018348
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- LW60736577
- Practice address
- 911 N 10TH PL
Renton, WA 98057-0009 - Phone
- (206) 320-2961
- Fax
- (206) 991-2061
- NPI assigned
- Aug 16, 2009
- Last updated
- Mar 19, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LW60736577 | WA | |
| Clinical Social Worker | 1041C0700X | LW60736577 | WA | Primary |
Addresses
Primary practice location
911 N 10TH PL
Renton, WA 98057-0009
Mailing address
PO Box 25608
Salt Lake City, UT 84125-0608
Phone (206) 320-4476
Other practice location 1
4929 W Fond Du Lac Ave
Milwaukee, WI 53216-2324
Phone (414) 871-6122 ext. 827
Other practice location 2
22707 SE 29th St
Sammamish, WA 98075-9532
Phone (425) 455-2845
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700018348 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LW60736577 | WA | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521417600000",
"number": "1700018348",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 25608",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841250608",
"telephone_number": "206-320-4476",
"fax_number": "206-568-7043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "911 N 10TH PL",
"city": "RENTON",
"state": "WA",
"postal_code": "980570009",
"telephone_number": "206-320-2961",
"fax_number": "206-991-2061"
}
],
"practiceLocations": [
{
"address_1": "4929 W Fond Du Lac Ave",
"address_purpose": "LOCATION",
"city": "Milwaukee",
"state": "WI",
"postal_code": "532162324",
"country_code": "US",
"telephone_number": "414-871-6122 x827",
"fax_number": "414-871-2552",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "22707 SE 29th St",
"address_purpose": "LOCATION",
"city": "Sammamish",
"state": "WA",
"postal_code": "980759532",
"country_code": "US",
"telephone_number": "425-455-2845",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "NEIDHARDT-GRUHL",
"first_name": "BRITTNEY",
"middle_name": "NEUMAN",
"name_prefix": "Ms.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-16",
"last_updated": "2018-03-19",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "WA",
"license": "LW60736577",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WA",
"license": "LW60736577",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1700018348",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Renton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.