Active NPI
Nishani Kweli Grigsby, LPC
- Professional Counselor
- Fort Worth, TX
National Provider Identifier
1013156256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 63440
- Practice address
- 3121 Collinsworth
Suite 14
Ft. Worth, TX 76107 - Phone
- (817) 343-2641
- Fax
- (817) 297-9519
- NPI assigned
- Feb 11, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 63440 | TX | Primary |
| School Counselor | 101YS0200X | TX |
Addresses
Primary practice location
3121 Collinsworth
Suite 14
Ft. Worth, TX 76107
Mailing address
5108 Azul LN.
Crowley, TX 76036
Phone (817) 343-2641
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20414501 | Medicaid | TX |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63440 | TX | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1285113600000",
"number": "1013156256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5108 AZUL LN.",
"city": "CROWLEY",
"state": "TX",
"postal_code": "76036",
"telephone_number": "817-343-2641",
"fax_number": "817-297-9519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3121 COLLINSWORTH",
"address_2": "SUITE 14",
"city": "FT. WORTH",
"state": "TX",
"postal_code": "76107",
"telephone_number": "817-343-2641",
"fax_number": "817-297-9519"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIGSBY",
"first_name": "NISHANI",
"middle_name": "KWELI",
"name_prefix": "Mrs.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-02-11",
"last_updated": "2010-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "63440",
"primary": true
},
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": "TX",
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "20414501",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.