Andrea Linette Grosskurth, LICSW
Social Worker, Clinical in Kenosha, WI. Individual provider (NPI-1).
NPI number1497016752
StatusActive
Last updated in NPPESNov 23, 2020
Details
- NPI
- 1497016752
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Andrea Linette Grosskurth
- Credential
- LICSW
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jun 4, 2012
- Certification date
- Nov 23, 2020
- Last updated
- Nov 23, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CLINICAL SOCIAL WORKER
- Can order and refer
- Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | 8609 | WI | Yes |
Other names
- Andrea Linette Johnson (Former Name)
Practice location
6809 122nd AveKenosha, WI 53142-7335
Phone 262-652-5522 · Fax 262-652-7228
Mailing address
6809 122nd AveKenosha, WI 53142-7335
Phone 262-652-5522 · Fax 262-652-7228
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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