Individual provider Active NPI

Grant Humphries III

  • Social Worker
  • Las Vegas, NV
National Provider Identifier
1205603479
Registry record updated Sep 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
12604-M Issued in NV
Practice address
720 S Jones Blvd
Las Vegas, NV 89107-3614
Phone
(702) 331-4874
NPI assigned
Dec 7, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 12604-M NV Primary

Addresses

Primary practice location

720 S Jones Blvd
Las Vegas, NV 89107-3614

Mailing address

720 S Jones Blvd
Las Vegas, NV 89107-3614
Phone (702) 331-4874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12604-MNVMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Elements of Motivation LLC CurrentSince Sep 21, 2025 Accepting new patients
Claudia Barraza PastSince Sep 21, 2025 Accepting new patients

Locations

720 S Jones Blvd
Las Vegas, NV 89107
Phone (702) 331-4874

Organizations & group practices 2

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": "1701907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1205603479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891073614",
            "telephone_number": "702-331-4874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 S JONES BLVD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891073614",
            "telephone_number": "702-331-4874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHRIES",
        "first_name": "GRANT",
        "name_prefix": "Mr.",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-07",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NV",
            "license": "12604-M",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; 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.