Individual provider Active NPI

Maryann Grochowski, LCSW

  • Clinical Social Worker
  • Milwaukee, WI
National Provider Identifier
1760570931
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1531 Issued in WI
Practice address
7330 W Layton Ave
American Behavioral Clinic
Milwaukee, WI 53227
Phone
(414) 281-1677
Fax
(414) 281-9884
NPI assigned
Oct 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1531 WI Primary

Addresses

Primary practice location

7330 W Layton Ave
American Behavioral Clinic
Milwaukee, WI 53227

Mailing address

7330 W Layton Ave
American Behavioral Clinic
Milwaukee, WI 53227
Phone (414) 281-1677

Other identifiers 1

IdentifierTypeStateIssuer
39593200MedicaidWI

Other names 1

  • Ms. Maryann Rebatzke Other name

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

LicenseStateTypeSpecialty
1531WIMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760570931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7330 W LAYTON AVE",
            "address_2": "AMERICAN BEHAVIORAL CLINIC",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53227",
            "telephone_number": "414-281-1677",
            "fax_number": "414-281-9884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7330 W LAYTON AVE",
            "address_2": "AMERICAN BEHAVIORAL CLINIC",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53227",
            "telephone_number": "414-281-1677",
            "fax_number": "414-281-9884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROCHOWSKI",
        "first_name": "MARYANN",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "1531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39593200",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARYANN",
            "last_name": "REBATZKE",
            "prefix": "MS.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.