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Active NPI 1376938613 Organization (Entity Type 2)

Todd Gjerdevig

Social Worker - Clinical • Grapevine, TX

About Todd Gjerdevig NPI 1376938613 Summary

Todd Gjerdevig is a verified healthcare organization specializing in Social Worker - Clinical operating in Grapevine, TX. Located at 1111 S MAIN ST, SUITE 132, this facility provides patient care and medical services under National Provider Identifier (NPI) 1376938613.

Administrative operations and authorized compliance are overseen by Todd Gjerdevig (Owner).

The facility is associated with 2 linked healthcare practitioners providing clinical services.

Facility Location & Contact Primary Location

Facility Address

1111 S Main St
Suite 132

Grapevine, TX 760515577

Telephone 8178655032

Authorized Official Information

Authorized Contact Name

Todd Gjerdevig , LCSW

Title / Role

Owner

Official Telephone

8179080296

Facility Classifications & Specialties

Social Worker - Clinical Primary Taxonomy

NUCC Taxonomy Code: 1041C0700X

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Affiliated Practitioners & Clinicians

Healthcare professionals and specialists practicing at this facility or affiliated group locations

2 Linked
Paul Boettcher NPI 1457715260

Behavior Analyst

Grapevine, TX

View Practitioner Profile →

Counselor - Professional

Grapevine, TX

View Practitioner Profile →

Facility & Registry History Timeline

Chronological log of verified NPI organization updates, branch relocations, and registry updates

6 Historical Events
NPI Profile Active April 03, 2015

NPI status registered as active in NPPES database

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Updated Practice Location April 03, 2015

Registered at 1111 S MAIN ST, SUITE 132, GRAPEVINE, TX 760515577 (Tel: 8178655032)

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Updated Business Mailing Address April 03, 2015

Registered at 1111 S MAIN ST, SUITE 132, GRAPEVINE, TX 760515577 (Tel: 8178655032)

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Organization / Clinic Name Updated April 03, 2015

Operating as TODD GJERDEVIG

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 03, 2015

Social Worker (License #37507 in TX)

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Initial NPI Registration & Enumeration April 03, 2015

First registered as active Healthcare Organization in NPPES Database.

Patient & Community Reviews

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NPI Organization Metadata

NPI Number: 1376938613
Entity Type:
Organization Organization (Hospital, Clinic, Group Practice) (Type 2 NPI)
Enumeration Date: April 03, 2015
Last Update: April 03, 2015

Mailing Address

1111 S Main St, Suite 132

Grapevine, TX 760515577

Phone: 8178655032

Public Domain Record This organization profile is sourced from public domain datasets published by CMS and NPPES under FOIA.
⚠️ Medical Disclaimer

Facility details are provided for public information only. In case of a medical emergency, call 911 immediately.