Ellen S Grudowski, LISW-S

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.1901820-SUPV Issued in OH

Practice address

476 Amesbury Dr
Gahanna, OH 43230-2370

Phone

(614) 653-1665

NPI assigned

Mar 14, 2017

Last updated

Feb 17, 2025By 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

Other identifiers 1

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

• Direct secure messaging: ellen.grudowski.1@28621.direct.athenahealth.com

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.

• Optum Behavioral Care of Ohio, Inc

  dba The Center for Cognitive and Behavioral Therapy of Ohio

  • Counseling Psychologist
  • Columbus, OH
  • NPI 1285400978
  Medicare reassignment NPD
• Optum Behavioral Care of Ohio, Inc.

  • Clinical Social Worker
  • Maryland Heights, MO
  • NPI 1528945623
  NPD

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1992246623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "476 AMESBURY DR",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432302370",
            "telephone_number": "614-653-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "476 AMESBURY DR",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432302370",
            "telephone_number": "614-653-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUDOWSKI",
        "first_name": "ELLEN",
        "middle_name": "S",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-14",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1901820-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2846675",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacquata Green
• Leslie M Green, M.D.
• Jacob H Gregerson, MD
• Sarah Elizabeth Grim, LISW-S
• Austin Michael Grist, DO
• Marissa Kathleen Gruenbaum, PA-C
• William Christopher Guinther, RPH
• Nicholas Gulla, PT, DPT
• Angela Renee Gunther, R.N.
• Zhinan Guo, SWT

• Clinical Social Worker in Gahanna, OH
• Providers in Gahanna, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2025; 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.