Provider Demographics
NPI:1972770634
Name:GRUENWALD, LOUISE ELLEN (MS LCSW CADCIII)
Entity type:Individual
Prefix:MRS
First Name:LOUISE
Middle Name:ELLEN
Last Name:GRUENWALD
Suffix:
Gender:F
Credentials:MS LCSW CADCIII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1692 HWY 53 N
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729
Mailing Address - Country:US
Mailing Address - Phone:715-830-8270
Mailing Address - Fax:715-830-8272
Practice Address - Street 1:1692 HWY 53 N
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729
Practice Address - Country:US
Practice Address - Phone:715-830-8270
Practice Address - Fax:715-830-8272
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-13
Last Update Date:2008-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3725-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical