Channing Gredvig, LCSW
NPI 1003113622 · Clinical Social Worker · San Diego, CA
Enrolled with Medicare as Practitioner - Clinical Social Worker · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Channing Gredvig, LCSW is a Clinical Social Worker provider in San Diego, CA (NPI 1003113622).
Provider details
- NPI number
- 1003113622
- Entity type
- Individual
- Primary specialty
- Clinical Social WorkerBehavioral Health & Social Service Providers
- Credential
- LCSW
- Sex
- Male
- Sole proprietor
- No
- License
- 64651 (CA)
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2011-02-16
- Last updated
- 2021-11-29
Frequently asked questions
- What is Channing Gredvig's NPI number?
- Channing Gredvig's National Provider Identifier (NPI) is 1003113622, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Channing Gredvig's specialty?
- Channing Gredvig is listed in the NPPES registry with a primary specialty of Clinical Social Worker (Behavioral Health & Social Service Providers).
- Where is Channing Gredvig located?
- Channing Gredvig's practice location on file with NPPES is 3420 Kenyon St, San Diego, CA 92110-5001.
- What is Channing Gredvig's phone number?
- The practice phone number listed in the NPPES registry for Channing Gredvig is (619) 221-6550.
- Does Channing Gredvig accept Medicare?
- Channing Gredvig is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Channing Gredvig's NPI active?
- Yes — Channing Gredvig's NPI (1003113622) is active in the NPPES registry as of the last update on 2021-11-29.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.