Individual provider Active NPI

Grace Ellul

  • Clinical Social Worker
  • Royal Oak, MI
National Provider Identifier
1043921232
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
117 W 3Rd St
Royal Oak, MI 48067-3831
Phone
(249) 965-6605
Fax
(313) 335-3136
NPI assigned
Dec 8, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

117 W 3Rd St
Royal Oak, MI 48067-3831

Mailing address

1407 Whitcomb Ave
Royal Oak, MI 48073-2011
Phone (231) 735-4585

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Insync

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

Practice roles

OrganizationSpecialtyStatusNew patients
Integrative Psyche, LLC CurrentSince Dec 1, 2022 Accepting new patients

Locations

10150 W National Ave
Ste 390
West Allis, WI 53227
Phone (414) 454-4430

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": "1670457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1043921232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1407 WHITCOMB AVE",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480732011",
            "telephone_number": "231-735-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W 3RD ST",
            "city": "ROYAL OAK",
            "state": "MI",
            "postal_code": "480673831",
            "telephone_number": "249-965-6605",
            "fax_number": "313-335-3136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLUL",
        "first_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-12-08",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Insync",
            "affiliation": "N",
            "address_1": "10150 W National Ave Ste 390",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272145",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Royal Oak, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.