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NPI Code Detail

MEDICARE: MS. CYNTHIA ANNE GROTA MSSW, ACSW

MEDICARE: MS. CYNTHIA ANNE GROTA MSSW, ACSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker829-123WI

General Provider Information

NPI Number : 1528011715
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CYNTHIA ANNE GROTA MSSW, ACSW
Provider Business Mailing Address
First Line : PO BOX 231
Second Line :
City : NEILLSVILLE
State : WI
Zip : 54456-0231
Country : US
Telephone Number : 715-743-4369
Fax Number :
Provider Business Practice Location Address
First Line : 517 COURT ST
Second Line : ROOM 503
City : NEILLSVILLE
State : WI
Zip : 54456-1971
Country : US
Telephone Number : 715-743-5208
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2006
Last Update Date : 07/08/2007

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