Provider Demographics
NPI:1225463813
Name:GRONSETH, ALLISON (LMSW)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:GRONSETH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:REHLING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:1202 WESTRAC DR, STE 400
Mailing Address - Street 2:205
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-8442
Mailing Address - Country:US
Mailing Address - Phone:701-280-9545
Mailing Address - Fax:701-280-0038
Practice Address - Street 1:1202 WESTRAC DR S STE 400
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-2356
Practice Address - Country:US
Practice Address - Phone:701-280-9545
Practice Address - Fax:701-280-0038
Is Sole Proprietor?:No
Enumeration Date:2013-09-13
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4361104100000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator