Provider Demographics
NPI:1386344596
Name:GROSSBERG, KAREN (MSW, LMSW)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:GROSSBERG
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 W LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:MI
Mailing Address - Zip Code:48009-4117
Mailing Address - Country:US
Mailing Address - Phone:248-227-8066
Mailing Address - Fax:
Practice Address - Street 1:801 W 11 MILE RD # 160
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-5200
Practice Address - Country:US
Practice Address - Phone:248-765-8343
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-06
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801067623104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker