Raegan Elizabeth Grant

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPCC.0019525 Issued in CO

Practice address

1942 Broadway Ste 314C
Boulder, CO 80302-5233

Phone

(720) 213-8142

NPI assigned

Aug 10, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1597017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1174134647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 S BOULDER CIR APT 6015",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034287",
            "telephone_number": "720-213-8142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1942 BROADWAY STE 314C",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803025233",
            "telephone_number": "720-213-8142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "RAEGAN",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-10",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPCC.0019525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trevor Graham, PSY.D.
• Vicky Graham, O.D.
• Vivienne Gramza
• Johanna Granger, LAC
• Dayna Granston, RN, RXN, CNS, APRN
• Amber Grantham
• John G Grantham, M.D.
• Andrea Grasmick, LPCC
• Cheryl A Grasmick, P.A.
• Mark S Grassman, MSW

• Mental Health Counselor in Boulder, CO
• Providers in Boulder, CO by specialty
• Mental Health Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2024; 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.