Individual provider Active NPI

Catrina Romona Grigsby-Thedford, LSW, CADC

  • Addiction (Substance Use Disorder) Counselor
  • Las Vegas, NV
National Provider Identifier
1043656663
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
01226 Issued in NV
Practice address
2121 E Flamingo Rd Ste 218
Las Vegas, NV 89119-5124
Phone
(702) 265-1153
NPI assigned
May 22, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X
Addiction (Substance Use Disorder) Counselor 101YA0400X 01226 NV Primary

Addresses

Primary practice location

2121 E Flamingo Rd Ste 218
Las Vegas, NV 89119-5124

Mailing address

2121 E Flamingo Rd Ste 218
Las Vegas, NV 89119-5124
Phone (702) 265-1153

Other practice location 1

6600 W Charleston Blvd Ste 132
Las Vegas, NV 89146-1067
Phone (702) 283-6215

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

LicenseStateTypeSpecialty
01226NVMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Autism & Behavioral Consulting Services Behavior Analyst Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1369180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654128000000",
    "number": "1043656663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 E FLAMINGO RD STE 218",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195124",
            "telephone_number": "702-265-1153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 E FLAMINGO RD STE 218",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195124",
            "telephone_number": "702-265-1153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6600 W Charleston Blvd Ste 132",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891461067",
            "country_code": "US",
            "telephone_number": "702-283-6215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRIGSBY-THEDFORD",
        "first_name": "CATRINA",
        "middle_name": "ROMONA",
        "name_prefix": "Mrs.",
        "credential": "LSW, CADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-22",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NV",
            "license": "01226",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; 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.