Robert Granquist, MA, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

2417 Issued in MN

Practice address

570 Professional Drive
Northfield, MN 55057

Phone

(301) 301-3412

NPI assigned

Mar 4, 2020

Last updated

Mar 4, 2020By the provider in NPPES

Sex

Male

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

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

Specialty

Mental Health Counselor

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Secure Base Counseling Center LLCGroup PAC ID 8628409299, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Secure Base Counseling Center LLC

  • Psychologist
  • Northfield, MN
  • NPI 1285905885
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1583280000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583280000000",
    "number": "1235764895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 PROFESSIONAL DRIVE",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "55057",
            "telephone_number": "301-301-3412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 PROFESSIONAL DRIVE",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "55057",
            "telephone_number": "301-301-3412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANQUIST",
        "first_name": "ROBERT",
        "credential": "MA, LPCC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-04",
        "last_updated": "2020-03-04",
        "certification_date": "2020-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "2417",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Glidden, LPCC
• Richard L Goodwin, MD
• Debra Mary Gottfried
• Laura Susan Graber, D.C
• Grand St Paul CVS LLC (CVS Pharmacy #16566)
• Nancy Lynn Gregerson, LPCC
• Jennifer L Grossman, PA
• Group Therapy Central (Northfield Dynamic Therapy)
• Robyn Gunderson, PHD
• James Robert Gutfleisch, O.D.

• Professional Counselor in Northfield, MN
• Providers in Northfield, MN by specialty
• Professional Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.