Jeanette Grant, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

992832 Issued in CO

Practice address

300 Colorado Ave
Pueblo, CO 81004-2006

Phone

(719) 543-8711

NPI assigned

Dec 27, 2011

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 CO

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

Medicare enrollment (NPD)

Enrolled

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.

• Pueblo Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Pueblo, CO
  • NPI 1770529950
  Medicare reassignment NPD
• Pueblo Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Pueblo, CO
  • NPI 1952071219
  NPD

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

{
    "created_epoch": "1324944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1356610901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 E ROUTT AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042117",
            "telephone_number": "719-543-8718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 COLORADO AVE",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810042006",
            "telephone_number": "719-543-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "JEANETTE",
        "credential": "L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-27",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "992832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicholas Bill Graff-Warenski
• Shirley Jean Gragg, LPN II,NREMT-B,CIC-C
• Lori Graham, M.A.
• Robert Joseph Graham, DC
• Gregory Charles Grahek, NP-BC
• Carrie Raye Gravatt, M.A., CCC-SLP
• Gary B Graves, DDS
• Jeanne Ellen Graves, RDH
• Felicia Gray
• Jim Gray

• Clinical Social Worker in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.