Stacy Elizabeth Grindling, PSY.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301016249 Issued in MI

Practice address

30503 Greenfield Rd
Southfield, MI 48076-1594

Phone

(248) 691-4744

NPI assigned

May 28, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Stacy Elizabeth Glabach Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: sgrindling86162@direct.beaumont.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Beaumont Medical Group- Specialty Services

  • Surgery Physician
  • Royal Oak, MI
  • NPI 1578072906
  Medicare reassignment

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

{
    "created_epoch": "1401235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603238400000",
    "number": "1043622889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26901 BEAUMONT BLVD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480333849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30503 GREENFIELD RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480761594",
            "telephone_number": "248-691-4744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRINDLING",
        "first_name": "STACY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-28",
        "last_updated": "2020-10-21",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": "071008832",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301016249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sgrindling86162@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "30503 Greenfield Rd",
            "city": "Southfield",
            "state": "MI",
            "country_code": "US",
            "postal_code": "480761594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "STACY",
            "last_name": "GLABACH",
            "middle_name": "ELIZABETH",
            "prefix": "DR.",
            "credential": "PSY.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jason Scott Grills, PHARMACIST
• Jamell Hakim Grimes
• Kathleen A Grimm, CRNA
• Stephanie Grimshaw, DPT
• Issac X Grinberg, MD
• Ashleigh Marie Groeneveld
• Grooming Arts Lounge and Gallery
• Sharritta Grooom
• Latonya Gross, RN
• Alexander Grossi, MD

• Psychologist in Southfield, MI
• Providers in Southfield, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.