Individual provider Active NPI

Caleb Alan Grosse

  • Mental Health Counselor
  • Oklahoma City, OK
National Provider Identifier
1265969166
Registry record updated May 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
4024 N Lincoln Blvd # 220
Oklahoma City, OK 73105-5207
Phone
(405) 843-4673
NPI assigned
May 22, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

4024 N Lincoln Blvd # 220
Oklahoma City, OK 73105-5207

Mailing address

5628 N Meridian Ave
Oklahoma City, OK 73112-1560
Phone (828) 593-8574

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

NPI Registry JSON

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

{
    "created_epoch": "1495411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1495411200000",
    "number": "1265969166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5628 N MERIDIAN AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731121560",
            "telephone_number": "828-593-8574"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4024 N LINCOLN BLVD # 220",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731055207",
            "telephone_number": "405-843-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSE",
        "first_name": "CALEB",
        "middle_name": "ALAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-22",
        "last_updated": "2017-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2017; 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.