Individual provider Active NPI

Aishia Grevenberg, LCSW

  • Clinical Social Worker
  • Las Vegas, NV
National Provider Identifier
1851535520
Registry record updated Jun 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6121-C Issued in NV
Practice address
5154 S Durango Dr
Ste 103
Las Vegas, NV 89113-3171
Phone
(702) 523-5226
Fax
(702) 834-4871
NPI assigned
Apr 27, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2013

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 4661-S NV
Clinical Social Worker 1041C0700X 6121-C NV Primary
School Social Worker 1041S0200X 6121-C NV

Addresses

Primary practice location

5154 S Durango Dr
Ste 103
Las Vegas, NV 89113-3171

Mailing address

33 Delighted Ave
North Las Vegas, NV 89031-1393
Phone (702) 523-5226

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4661-SNVMDSocial Worker
6121-CNVMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370304000000",
    "number": "1851535520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 DELIGHTED AVE",
            "city": "NORTH LAS VEGAS",
            "state": "NV",
            "postal_code": "890311393",
            "telephone_number": "702-523-5226",
            "fax_number": "702-834-4871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5154 S DURANGO DR",
            "address_2": "STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891133171",
            "telephone_number": "702-523-5226",
            "fax_number": "702-834-4871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREVENBERG",
        "first_name": "AISHIA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-04-27",
        "last_updated": "2013-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NV",
            "license": "4661-S",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NV",
            "license": "6121-C",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NV",
            "license": "6121-C",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; 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.