Individual provider Active NPI

Cody L Granda, M.S., LMFT

  • Marriage & Family Therapist
  • Minneapolis, MN
National Provider Identifier
1194976555
Registry record updated May 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2455 Issued in MN
Practice address
5354 Parkdale Dr
Second Floor
Minneapolis, MN 55416-1603
Phone
(651) 645-5323
NPI assigned
Oct 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 15, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2455 MN Primary

Addresses

Primary practice location

5354 Parkdale Dr
Second Floor
Minneapolis, MN 55416-1603

Mailing address

5354 Parkdale Dr
Second Floor
Minneapolis, MN 55416
Phone (651) 645-5323

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260320002662 MN Practitioner - Marriage and Family Therapist 8628412301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

PO Box
Dallas, TX 75373

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2455MNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Appalachian Counseling Center LLC CurrentSince Jan 12, 2024 Accepting new patients
Edc of Denver, LLC Past Accepting new patients

Locations

207 Fairmont Ave
Fairmont, WV 26554
Phone (681) 404-6869

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1222992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431648000000",
    "number": "1194976555",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5354 PARKDALE DR",
            "address_2": "SECOND FLOOR",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "55416",
            "telephone_number": "651-645-5323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5354 PARKDALE DR",
            "address_2": "SECOND FLOOR",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554161603",
            "telephone_number": "651-645-5323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDA",
        "first_name": "CODY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "M.S., LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-03",
        "last_updated": "2015-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "2455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.