Organization Active NPI

Grander Peace Counseling LLC

  • Community/Behavioral Health Agency
  • Saint Paul, MN
National Provider Identifier
1013486505
Registry record updated Oct 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
GRANDER PEACE COUNSELING LLC
Practice address
658 Grand Ave Ste 201
Saint Paul, MN 55105-3492
Phone
(612) 454-1656
Fax
(651) 560-3768
NPI assigned
Nov 14, 2018
Last updated
Oct 6, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2025

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

Authorized official

Name
Sheena C O'Brien, MA LPNPI 1598897373
Title
Owner/Psychologist
Phone
(612) 454-1656

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

658 Grand Ave Ste 201
Saint Paul, MN 55105-3492

Mailing address

658 Grand Ave Ste 201
Saint Paul, MN 55105-3492
Phone (612) 454-1656

Other practice location 1

1619 Dayton Ave Ste 107
Saint Paul, MN 55104-6220
Phone (612) 454-1656

Other practice location 2

4756 Banning Ave Ste 210
White Bear Lake, MN 55110-3206
Phone (612) 454-1656

Other practice location 3

790 Cleveland Ave S Ste 217
Saint Paul, MN 55116-3845
Phone (612) 454-1656

Other practice location 4

1409 Willow St Ste 100
Minneapolis, MN 55403-2249
Phone (612) 454-1656

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, SD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190128001439 MN Part B Supplier - Clinic/Group Practice 6204173362 Receives reassigned benefits from 13 practitioners
Practice locations: Saint Paul, MN
O20260219000954 SD Part B Supplier - Clinic/Group Practice 6204173362 Receives reassigned benefits from 1 practitioner
Practice locations: Sioux Falls, SD

National Provider Directory

National Provider Directory

Locations

1409 Willow St
Ste 100
Minneapolis, MN 55403
Phone (612) 454-1656

1619 Dayton Ave
Ste 107
Saint Paul, MN 55104
Phone (612) 454-1656

658 Grand Ave
Ste 201
Saint Paul, MN 55105
Phone (612) 454-1656

4756 Banning Ave
Ste 210
White Bear Lake, MN 55110
Phone (612) 454-1656

122 S Phillips Ave
Ste 203
Sioux Falls, SD 57104
Phone (612) 454-1656

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759708800000",
    "number": "1013486505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "658 GRAND AVE STE 201",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053492",
            "telephone_number": "612-454-1656",
            "fax_number": "651-560-3768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 GRAND AVE STE 201",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551053492",
            "telephone_number": "612-454-1656",
            "fax_number": "651-560-3768"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1619 Dayton Ave Ste 107",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551046220",
            "country_code": "US",
            "telephone_number": "612-454-1656",
            "fax_number": "651-560-3768",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4756 Banning Ave Ste 210",
            "address_purpose": "LOCATION",
            "city": "White Bear Lake",
            "state": "MN",
            "postal_code": "551103206",
            "country_code": "US",
            "telephone_number": "612-454-1656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "790 Cleveland Ave S Ste 217",
            "address_purpose": "LOCATION",
            "city": "Saint Paul",
            "state": "MN",
            "postal_code": "551163845",
            "country_code": "US",
            "telephone_number": "612-454-1656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1409 Willow St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554032249",
            "country_code": "US",
            "telephone_number": "612-454-1656",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRANDER PEACE COUNSELING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-14",
        "last_updated": "2025-10-06",
        "certification_date": "2025-10-06",
        "status": "A",
        "authorized_official_last_name": "O'BRIEN",
        "authorized_official_first_name": "SHEENA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "612-454-1656",
        "authorized_official_credential": "MA LP"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.