Keri Innis-Grant, MSW PENDING

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

193200000X Issued in MA

Practice address

108 Grove Street
Ste LL11
Worcester, MA 01605

Phone

(508) 304-7499

Fax

(774) 420-7255

NPI assigned

Aug 9, 2018

Sex

Female

Sole proprietor

No

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

Practice roles

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.

• Community First Adult Foster Care

  • Adult Care Home Facility
  • Worcester, MA
  • NPI 1194466920
  NPD
• Revidas LLC

  • Mental Health Counselor
  • Worcester, MA
  • NPI 1528410610
  NPD (past)

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

{
    "created_epoch": "1533772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533772800000",
    "number": "1154800290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 GROVE ST STE LL11",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052677",
            "telephone_number": "508-304-7499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 GROVE STREET",
            "address_2": "STE LL11",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01605",
            "telephone_number": "508-304-7499",
            "fax_number": "774-420-7255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "108 Grove St Ste Ll11",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016052677",
            "country_code": "US",
            "telephone_number": "508-304-7499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "INNIS-GRANT",
        "first_name": "KERI",
        "credential": "MSW PENDING",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-09",
        "last_updated": "2018-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MA",
            "license": "193200000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Tyler Ingalls
• Isha Vijaykumar Ingle, MD
• Bethany M Ingram, PHARM D
• Jamie Ingram, PTA
• Gabriella Elizabeth Inman
• Mary R Innis, RN PC
• Peter Gitobu Inoti
• Insight Home Care Solutions
• Instant Transportation, LLC
• Institute for Trauma and Healing

• Professional Counselor in Worcester, MA
• Providers in Worcester, MA by specialty
• Professional Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2018; 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.