Active NPI
Allan Grill, CRC, MFT
- Marriage & Family Therapist
- Santa Fe, NM
National Provider Identifier
1083639132
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MFC 24930
- Practice address
- 3201C Zafarano Dr # 300
Santa Fe, NM 87507-2668 - Phone
- (510) 232-1630
- NPI assigned
- Jul 12, 2006
- Last updated
- Feb 9, 2024
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MFC 24930 | CA | Primary |
Addresses
Primary practice location
3201C Zafarano Dr # 300
Santa Fe, NM 87507-2668
Mailing address
3201C Zafarano Dr # 300
Santa Fe, NM 87507-2668
Phone (510) 232-1630
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 8, 2024 through Feb 8, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MFC 24930 | CA | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707436800000",
"number": "1083639132",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3201C ZAFARANO DR # 300",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875072668",
"telephone_number": "510-232-1630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3201C ZAFARANO DR # 300",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875072668",
"telephone_number": "510-232-1630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRILL",
"first_name": "ALLAN",
"credential": "CRC, MFT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-12",
"last_updated": "2024-02-09",
"certification_date": "2024-02-08",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": "MFC 24930",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.