Individual provider Active NPI

Tabitha Gronock, LMSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1780901660
Registry record updated Jan 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
73079710 Issued in NY
Practice address
2214 Stillwell Ave
Brooklyn, NY 11223-4250
Phone
(718) 947-3427
Fax
(718) 947-3285
NPI assigned
Apr 30, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2014

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 73079710 NY Primary

Addresses

Primary practice location

2214 Stillwell Ave
Brooklyn, NY 11223-4250

Mailing address

140 Jackson Ave
Staten Island, NY 10305-4740
Phone (347) 205-3069

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
73079710NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Block Institute, Inc. Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390780800000",
    "number": "1780901660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 JACKSON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103054740",
            "telephone_number": "347-205-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2214 STILLWELL AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112234250",
            "telephone_number": "718-947-3427",
            "fax_number": "718-947-3285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRONOCK",
        "first_name": "TABITHA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-30",
        "last_updated": "2014-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "73079710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; 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.