Joel Grostephan, Licsw, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

20930 Issued in MN

Legal business name

JOEL GROSTEPHAN, LICSW, LLC

Practice address

3011 36TH Ave S Ste 10
Minneapolis, MN 55406-2800

Phone

(612) 839-5853

NPI assigned

Oct 5, 2015

Last updated

Oct 5, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Joel Paul Grostephan, LICSWNPI 1326387051

Title

Therapist/Owner

Phone

(612) 839-5853

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joel P. Grostephan, MSW, LICSW

  • Social Worker
  • Minneapolis, MN
  • NPI 1326387051
  NPD Authorized official

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1444003200000",
    "number": "1730559584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3011 36TH AVE. S., #10",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55406",
            "telephone_number": "612-839-5853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3011 36TH AVE S STE 10",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554062800",
            "telephone_number": "612-839-5853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOEL GROSTEPHAN, LICSW, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-05",
        "last_updated": "2015-10-05",
        "status": "A",
        "authorized_official_last_name": "GROSTEPHAN",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "612-839-5853",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MN",
            "license": "20930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Community/Behavioral Health Agency in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Community/Behavioral Health Agency in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; 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.