Individual provider Active NPI

Stephanie A Grade, TLMHC

  • Mental Health Counselor
  • Carroll, IA
National Provider Identifier
1356074272
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
112820 Issued in IA
Practice address
23751 Highway 30
Carroll, IA 51401-8505
Phone
(712) 792-9266
Fax
(712) 792-1457
NPI assigned
Jul 7, 2022
Last updated
Jul 7, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 112820 IA Primary

Addresses

Primary practice location

23751 Highway 30
Carroll, IA 51401-8505

Mailing address

PO Box 427
Carroll, IA 51401-0427
Phone (712) 792-9266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260313000860 IA Practitioner - Mental Health Counselor 3678056033 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Opportunities IncGroup PAC ID 4789163361, 2 clinicians

Practice addresses (Care Compare)

23751 Hwy 30
Carroll, IA 51401-8505
Phone (712) 792-9266

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
112820IAMDMental Health Counselor

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1657152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1356074272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 427",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514010427",
            "telephone_number": "712-792-9266",
            "fax_number": "712-792-1457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23751 HIGHWAY 30",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514018505",
            "telephone_number": "712-792-9266",
            "fax_number": "712-792-1457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADE",
        "first_name": "STEPHANIE",
        "middle_name": "A",
        "credential": "TLMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "112820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carroll, IA

Sources for this page

Verify at the official NPI Registry.