Gail Johanna Grogan Pedersen, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

13610 Issued in MN

Practice address

1355 Spencer Rd W
Saint Paul, MN 55108-5206

Phone

(651) 983-3743

NPI assigned

May 2, 2022

Last updated

May 2, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Practice roles

Locations

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.

• Brave Choices, Inc.

  • Clinical Social Worker
  • Saint Paul, MN
  • NPI 1740637750
  Medicare reassignment NPD

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

{
    "created_epoch": "1651449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651449600000",
    "number": "1952046294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 SPENCER RD W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085206",
            "telephone_number": "651-983-3743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 SPENCER RD W",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551085206",
            "telephone_number": "651-983-3743"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROGAN PEDERSEN",
        "first_name": "GAIL",
        "middle_name": "JOHANNA",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-02",
        "last_updated": "2022-05-02",
        "certification_date": "2022-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "13610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashlynn K Grisim
• John R Grittner
• Grittners Dental PLLC (Highgrove Dental Care)
• David Alan Griver, MD
• Justin Groenewold, M.D.
• Mary Patricia Grom, D.C.
• Joe Groninga, PSYD
• Jannica L Groom, MD
• David Joseph Groppoli, MD
• Matthew Groschen, AU.D

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, 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 May 2, 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.