Provider Demographics
NPI:1871637330
Name:GROHMANN, WILLIAM H (LICSW)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:H
Last Name:GROHMANN
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 N PLEASANT ST
Mailing Address - Street 2:SUITE 205
Mailing Address - City:AMHERST
Mailing Address - State:MA
Mailing Address - Zip Code:01002-1738
Mailing Address - Country:US
Mailing Address - Phone:413-256-6211
Mailing Address - Fax:413-256-6211
Practice Address - Street 1:48 N PLEASANT ST
Practice Address - Street 2:SUITE 205
Practice Address - City:AMHERST
Practice Address - State:MA
Practice Address - Zip Code:01002-1738
Practice Address - Country:US
Practice Address - Phone:413-256-6211
Practice Address - Fax:413-256-6211
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA10169891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP20676Medicare ID - Type Unspecified