Active NPI
Cheryl Anhara Grant, MSW
- Behavior Technician
- Detroit, MI
National Provider Identifier
1053704809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 17421 Telegraph Rd
Detroit, MI 48219-3165 - Phone
- (313) 460-0024
- NPI assigned
- Mar 17, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801097763 | MI | |
| Behavior Technician | 106S00000X | Primary |
Addresses
Primary practice location
17421 Telegraph Rd
Detroit, MI 48219-3165
Mailing address
7194 Colchester LN
Ypsilanti, MI 48197-1871
Phone (313) 460-0024
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053704809 | Medicaid | MI |
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 |
|---|---|---|---|
| 6801097763 | MI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1426550400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591228800000",
"number": "1053704809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7194 COLCHESTER LN",
"city": "YPSILANTI",
"state": "MI",
"postal_code": "481971871",
"telephone_number": "313-460-0024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17421 TELEGRAPH RD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482193165",
"telephone_number": "313-460-0024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "CHERYL",
"middle_name": "ANHARA",
"credential": "MSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-03-17",
"last_updated": "2020-06-04",
"certification_date": "2020-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801097763",
"primary": false
},
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1053704809",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.