Individual provider Active NPI

Heidi Lynn Grantz, LCSW

  • Clinical Social Worker
  • New Haven, CT
National Provider Identifier
1881863439
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
006203 Issued in CT
Practice address
350 George St
New Haven, CT 06511-6617
Phone
(203) 737-5814
Fax
(203) 737-5455
NPI assigned
Feb 28, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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 006203 CT Primary

Addresses

Primary practice location

350 George St
New Haven, CT 06511-6617

Mailing address

230 S Frontage Rd
P.O. Box 207900
New Haven, CT 06519-1124
Phone (203) 737-5814

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
6203CTMDFamily Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1204156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1881863439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 S FRONTAGE RD",
            "address_2": "P.O. BOX 207900",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191124",
            "telephone_number": "203-737-5814",
            "fax_number": "203-785-6293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 GEORGE ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065116617",
            "telephone_number": "203-737-5814",
            "fax_number": "203-737-5455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANTZ",
        "first_name": "HEIDI",
        "middle_name": "LYNN",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-28",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "006203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; 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.