Individual provider Active NPI

Emily Joyce Grandusky, MS, CRC

  • Professional Counselor
  • Ellamore, WV
National Provider Identifier
1003019274
Registry record updated Jul 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1054 Issued in WV
Practice address
165 Glenmil LN
Ellamore, WV 26267-7020
Phone
(304) 997-2835
NPI assigned
Jun 6, 2007
Last updated
Jul 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 10, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X
Counselor 101Y00000X 1054 WV
Mental Health Counselor 101YM0800X 1054 WV
Professional Counselor 101YP2500X 1054 WV Primary
Addiction (Substance Use Disorder) Counselor 101YA0400X 1054 WV

Addresses

Primary practice location

165 Glenmil LN
Ellamore, WV 26267-7020

Mailing address

165 Glenmil LN
Ellamore, WV 26267-7020
Phone (304) 997-2835

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
1054WVMDCounselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783641600000",
    "number": "1003019274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 GLENMIL LN",
            "city": "ELLAMORE",
            "state": "WV",
            "postal_code": "262677020",
            "telephone_number": "304-997-2835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 GLENMIL LN",
            "city": "ELLAMORE",
            "state": "WV",
            "postal_code": "262677020",
            "telephone_number": "304-997-2835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDUSKY",
        "first_name": "EMILY",
        "middle_name": "JOYCE",
        "name_prefix": "Ms.",
        "credential": "MS, CRC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2026-07-10",
        "certification_date": "2026-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WV",
            "license": "1054",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WV",
            "license": "1054",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "1054",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WV",
            "license": "1054",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellamore, WV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.