Jullian Griesheimer, LICDC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2103011 Issued in OH

Practice address

729 S Walnut St
Marysville, OH 43040-1643

Phone

(937) 642-9555

Fax

(937) 738-7326

NPI assigned

Dec 27, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/wingsrecoveryohio/r4/

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.

• Wings Support and Recovery

  • Community/Behavioral Health Agency
  • Marysville, OH
  • NPI 1669940995

  Addiction (Substance Use Disorder), OH

  Medicare reassignment NPD Authorized official
• Wings Enrichment Center

  • Community/Behavioral Health Agency
  • Marysville, OH
  • NPI 1104213925
  NPD Authorized official
• New Path Clinical Services LLC

  • Clinical Social Worker
  • Lakeview, OH
  • NPI 1104712520

  Clinical

  NPD

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

{
    "created_epoch": "1514332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632355200000",
    "number": "1982110029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "729 S WALNUT ST",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430401643",
            "telephone_number": "937-642-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "729 S WALNUT ST",
            "city": "MARYSVILLE",
            "state": "OH",
            "postal_code": "430401643",
            "telephone_number": "937-642-9555",
            "fax_number": "937-738-7326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIESHEIMER",
        "first_name": "JULLIAN",
        "credential": "LICDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-27",
        "last_updated": "2021-09-23",
        "certification_date": "2021-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2103011",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC.161547",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gastin Green
• Kinley Green
• Polly L Green
• Tara Rachele Green, PHARMD
• Angelina Greer, MSW, LSW
• Christine A Grimes, LSW
• Tonya M Grubb
• Shelley Gruetter
• Steven F Gulla, D.C.
• Guster Losey & Mack DDS Inc

• All providers in Marysville, OH
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2021; 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.