Kristal Grigsby, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

20617 Issued in MN

Practice address

1216 Ryans Rd
Worthington, MN 56187-1722

Phone

(507) 372-2921

Fax

(507) 372-5789

NPI assigned

Nov 22, 2013

Last updated

Feb 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of Scott

  dba Scott County Mental Health Center

  • Psychologist
  • Shakopee, MN
  • NPI 1841299443
  Medicare reassignment
• County of Scott

  • Community/Behavioral Health Agency
  • Shakopee, MN
  • NPI 1710047535
  NPD (past)

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

{
    "created_epoch": "1385078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1801226188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 4TH AVE W",
            "city": "SHAKOPEE",
            "state": "MN",
            "postal_code": "553791220",
            "telephone_number": "952-496-8565",
            "fax_number": "952-496-8355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1216 RYANS RD",
            "city": "WORTHINGTON",
            "state": "MN",
            "postal_code": "561871722",
            "telephone_number": "507-372-2921",
            "fax_number": "507-372-5789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIGSBY",
        "first_name": "KRISTAL",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-11-22",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "20617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa K Gerdes, MD
• Barbara Lynn Gould, M.D.
• Grant R. Sorensen, DDS
• Jessica Grant, LICSW
• Gravon's Natural Chiropractic Center P a
• Tracy John Grossman, DDS
• Tonya Anne Grothe-Bumgardner, MS
• Kathy Gruis, MA, LPCC
• Kim D Grymaloski, M.D.
• Mitzi Johali Guizar Cardenas

• Clinical Social Worker in Worthington, MN
• Providers in Worthington, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.