Kristen Grimsrud, LCPC
Individual provider Active NPI Mental Health Counselor · Worden, MT
NPI 1134715469 · NPPES record last updated Dec 21, 2020
Key facts
- NPI
- 1134715469
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 46699 (MT)
- Practice address
- 1477 Ash St
Worden, MT 59088-2221 - Phone
- (406) 234-0234
- Fax
- (406) 234-0235
- NPI assigned
- Dec 21, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240514002905 | MT | Practitioner - Mental Health Counselor | 2567803174 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46699 | MT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastern Montana Community Mental Health Center | Mental Health | Current |
Accepting new patients |
Locations
2508 Wilson St
Miles City, MT 59301
Phone (406) 234-0234
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 46699 | MT | Yes |
Addresses
Primary practice location
1477 Ash St
Worden, MT 59088-2221
Mailing address
PO Box 1530
Miles City, MT 59301-1530
Phone (406) 234-0234
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | www.emcmhc@midrivers.com | Direct |
Other providers in Worden, MT
- Analaigh Heals
- Joy A. Eshleman
- Heart of Montana Eldercare LLC
- Amanda D Heppner
- Huntley Project School District
- St. Vincent Healthcare
- Worden Fire Department, Inc
All providers in Worden, MT · Mental Health Counselor in Montana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 21, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.