Active NPI
Dawn Gross, MSW, LCSW
- Clinical Social Worker
- Kirkwood, MO
National Provider Identifier
1730692260
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2017037199
- Practice address
- 11040 Manchester Rd
Kirkwood, MO 63122-1203 - Phone
- (636) 368-7655
- NPI assigned
- Nov 6, 2017
- Reactivated
- Jan 10, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2017037199 | MO | Primary |
Addresses
Primary practice location
11040 Manchester Rd
Kirkwood, MO 63122-1203
Mailing address
911 Grovena Dr
Saint Louis, MO 63126-1110
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 |
|---|---|---|---|
| 2017037199 | MO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1509926400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515542400000",
"number": "1730692260",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "911 GROVENA DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631261110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11040 MANCHESTER RD",
"city": "KIRKWOOD",
"state": "MO",
"postal_code": "631221203",
"telephone_number": "636-368-7655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROSS",
"first_name": "DAWN",
"credential": "MSW, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-11-06",
"last_updated": "2018-01-10",
"deactivation_date": "2017-12-01",
"reactivation_date": "2018-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2017037199",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kirkwood, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.