Edi Lane Griggs Halstead

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

176780 Issued in AK

Practice address

3647 Clark Wolverine Road
Palmer, AK 99645

Phone

(907) 761-7426

NPI assigned

Dec 15, 2021

Sex

Female

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 AK

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

The Mental Health Co-Op LLCGroup PAC ID 0143747881, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• The Mental Health Co-Op LLC

  • Clinical Social Worker
  • Palmer, AK
  • NPI 1932832086
  Medicare reassignment Care Compare group NPD
• Silver Moon Mental Health Therapy LLC

  • Community/Behavioral Health Agency
  • Palmer, AK
  • NPI 1902530843
  NPD Authorized official

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

{
    "created_epoch": "1639526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1346909546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 S BODENBURG LOOP",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "996457617",
            "telephone_number": "907-521-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3647 CLARK WOLVERINE ROAD",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "99645",
            "telephone_number": "907-761-7426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIGGS HALSTEAD",
        "first_name": "EDI",
        "middle_name": "LANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-12-15",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "AK",
            "license": "176780",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Green Hills Assisted Living Home, LLC
• Green Psychological Services, LLC
• Greg O. Lund, M.D.
• Aidan Griener
• Brandon Griffin
• Lillie Michelle Grimes, PH.D
• Raymond Charles Grogan, RPH
• Robert A Grogan, RPH
• Valerie Groseclose
• David Anderson Grove Jr., MD

• Mental Health Counselor in Palmer, AK
• Providers in Palmer, AK by specialty
• Mental Health Counselor in Alaska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.