Rene Gapasin Grino Jr.

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH21690 Issued in FL

Practice address

555 Walton Rd
Defuniak Springs, FL 32433-1538

Phone

(850) 892-1111

NPI assigned

Oct 29, 2021

Last updated

Oct 29, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1635465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1083378582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2718 RIVER OAK DR",
            "city": "EGLIN AFB",
            "state": "FL",
            "postal_code": "325421439",
            "telephone_number": "702-722-9451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 WALTON RD",
            "city": "DEFUNIAK SPRINGS",
            "state": "FL",
            "postal_code": "324331538",
            "telephone_number": "850-892-1111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2718 River Oak Dr",
            "address_purpose": "LOCATION",
            "city": "Eglin AFB",
            "state": "FL",
            "postal_code": "325421439",
            "country_code": "US",
            "telephone_number": "702-722-9451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRINO",
        "first_name": "RENE",
        "middle_name": "GAPASIN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-29",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH21690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Defuniak Springs, FL
• Providers in Defuniak Springs, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; 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.