Individual provider Active NPI

Carolyn Lee Grinstead, LICSW

  • Clinical Social Worker
  • Paxton, MA
National Provider Identifier
1992051080
Registry record updated Dec 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
215704 Issued in MA
Practice address
6 Baxter Dr
Paxton, MA 01612-1275
Phone
(508) 799-5756
NPI assigned
Jul 26, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 215704 MA Primary

Addresses

Primary practice location

6 Baxter Dr
Paxton, MA 01612-1275

Mailing address

6 Baxter Dr
Paxton, MA 01612-1275
Phone (508) 799-5756

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
215704MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1343260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356480000000",
    "number": "1992051080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 BAXTER DR",
            "city": "PAXTON",
            "state": "MA",
            "postal_code": "016121275",
            "telephone_number": "508-799-5756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 BAXTER DR",
            "city": "PAXTON",
            "state": "MA",
            "postal_code": "016121275",
            "telephone_number": "508-799-5756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINSTEAD",
        "first_name": "CAROLYN",
        "middle_name": "LEE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-26",
        "last_updated": "2012-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "215704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paxton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2012; 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.