Individual provider Active NPI

Kathleen Ruth Groessbrink, LCSW

  • Social Worker
  • West Caldwell, NJ
National Provider Identifier
1952469223
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
SC 13900 Issued in NJ
Practice address
1140 Bloomfield Avenue
Suite 212
West Caldwell, NJ 07006
Phone
(973) 239-4905
Fax
(973) 239-8968
NPI assigned
Dec 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X SC 13900 NJ Primary

Addresses

Primary practice location

1140 Bloomfield Avenue
Suite 212
West Caldwell, NJ 07006

Mailing address

9 Wayland Drive
Verona, NJ 07044
Phone (973) 239-4905

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
SC 13900NJMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952469223",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 WAYLAND DRIVE",
            "city": "VERONA",
            "state": "NJ",
            "postal_code": "07044",
            "telephone_number": "973-239-4905",
            "fax_number": "973-239-8968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 BLOOMFIELD AVENUE",
            "address_2": "SUITE 212",
            "city": "WEST CALDWELL",
            "state": "NJ",
            "postal_code": "07006",
            "telephone_number": "973-239-4905",
            "fax_number": "973-239-8968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROESSBRINK",
        "first_name": "KATHLEEN",
        "middle_name": "RUTH",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "SC 13900",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Caldwell, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.