Individual provider Active NPI

Marilyn L Grubbs, LPC

  • Professional Counselor
  • Carrboro, NC
National Provider Identifier
1255592705
Registry record updated Oct 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
7005 Issued in NC
Practice address
501 Hillsborough Rd
Carrboro, NC 27510-1227
Phone
(919) 619-5758
NPI assigned
Jun 18, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 7005 NC Primary

Addresses

Primary practice location

501 Hillsborough Rd
Carrboro, NC 27510-1227

Mailing address

501 Hillsborough Rd
Carrboro, NC 27510-1227
Phone (919) 619-5758

Other identifiers 1

IdentifierTypeStateIssuer
6103980MedicaidNC

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
7005NCMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1382659200000",
    "number": "1255592705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 HILLSBOROUGH RD",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "275101227",
            "telephone_number": "919-619-5758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 HILLSBOROUGH RD",
            "city": "CARRBORO",
            "state": "NC",
            "postal_code": "275101227",
            "telephone_number": "919-619-5758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBBS",
        "first_name": "MARILYN",
        "middle_name": "L",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-18",
        "last_updated": "2013-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "7005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6103980",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrboro, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2013; 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.