Individual provider Active NPI

Antonia G. Grimolizzi-Jensen, LISW

  • Clinical Social Worker
  • Wauseon, OH
National Provider Identifier
1962577510
Registry record updated Jun 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
I7266 Issued in OH
Practice address
1115 N Shoop Ave
Wauseon, OH 43567-1857
Phone
(419) 335-6122
Fax
(419) 318-4157
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X I.0007266 OH
Clinical Social Worker 1041C0700X I7266 OH Primary

Addresses

Primary practice location

1115 N Shoop Ave
Wauseon, OH 43567-1857

Mailing address

PO Box 146
Wauseon, OH 43567-0146
Phone (419) 335-6122

Other identifiers 1

IdentifierTypeStateIssuer
0254416MedicaidOH

Other names 1

  • Mrs. Antonia G Jensen Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20040809001466 OH Practitioner - Clinical Social Worker 8022089515 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Antonia Jensen and Associates LLCGroup PAC ID 0042281537, 2 clinicians

Practice addresses (Care Compare)

1115 N Shoop Ave
Wauseon, OH 43567-1857
Phone (419) 335-6122

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.0007266OHMDClinical Social Worker
I7266OHMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Antonia Jensen & Associates, LLC Clinical CurrentSince Aug 1, 2001 Accepting new patients

Locations

516 E High St
Ste Ac
Bryan, OH 43506

3478 W Elm St
Lima, OH 45807
Phone (419) 335-6122

1000 Westmoreland Ave
Ste B
Napoleon, OH 43545

1115 N Shoop Ave
Ste 1
Wauseon, OH 43567
Phone (419) 335-6122

1115 N Shoop Ave
Wauseon, OH 43567
Phone (419) 335-6122

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750896000000",
    "number": "1962577510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 146",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435670146",
            "telephone_number": "419-335-6122",
            "fax_number": "419-318-4157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1115 N SHOOP AVE",
            "city": "WAUSEON",
            "state": "OH",
            "postal_code": "435671857",
            "telephone_number": "419-335-6122",
            "fax_number": "419-318-4157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIMOLIZZI-JENSEN",
        "first_name": "ANTONIA",
        "middle_name": "G.",
        "name_prefix": "Mrs.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2025-06-26",
        "certification_date": "2025-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.0007266",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I7266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0254416",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANTONIA",
            "last_name": "JENSEN",
            "middle_name": "G",
            "prefix": "MRS.",
            "credential": "LISW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Wauseon, OH

Sources for this page

Verify at the official NPI Registry.