Christiana Dorian Grotlisch, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

115305 Issued in CA

Practice address

31450 Broad Beach Rd
Malibu, CA 90265-2669

Phone

(310) 881-8457

NPI assigned

Nov 7, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1510012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685404800000",
    "number": "1922511401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31450 BROAD BEACH RD",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902652669",
            "telephone_number": "310-499-3145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31450 BROAD BEACH RD",
            "city": "MALIBU",
            "state": "CA",
            "postal_code": "902652669",
            "telephone_number": "310-881-8457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROTLISCH",
        "first_name": "CHRISTIANA",
        "middle_name": "DORIAN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-07",
        "last_updated": "2023-05-30",
        "certification_date": "2023-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "98118",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "115305",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristy Graham, FNP-BC
• Grasshopper House, LLC
• Sage Grazer
• Adam Dov Greenberg, L. AC.
• Lauren M Greenman, PA-C
• Linda Marie Haack, PHD
• Evan Rhys Haines, PSYD
• Anthony John Hall, D.C.
• Kristy Lynn Hamilton, LCSW
• Karen Hannigan, M.S., CCC-SLP

• Clinical Social Worker in Malibu, CA
• Providers in Malibu, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2023; 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.