Jorge Eduardo Grandela, MA/PSYD

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701002347 Issued in VA

Practice address

79 E. Windsor Blvd
Windsor, VA 23487

Phone

(757) 242-9988

NPI assigned

Jul 4, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Comprehensive Psychological Services

  • Professional Counselor
  • Chesapeake, VA
  • NPI 1598861387

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1376573469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 SEEMAN RD",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234522457",
            "telephone_number": "757-498-8138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 E. WINDSOR BLVD",
            "city": "WINDSOR",
            "state": "VA",
            "postal_code": "23487",
            "telephone_number": "757-242-9988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANDELA",
        "first_name": "JORGE",
        "middle_name": "EDUARDO",
        "name_prefix": "Mr.",
        "credential": "MA/PSYD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0710101723",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "VA",
            "license": "0718000171",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701002347",
            "primary": true
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "VA",
            "license": "0717001060",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Eilers
• Family Ties Behavioral Health LLC
• Cassidy Feldt
• Davis Wayne Gardner, DDS
• Lorrie Saunders Gaskins, LPC
• Harold F. Demsko, D.D.S.,P.C.
• Sharon Fohl Hasty, RPH
• Allison Redd Holt, PHARMD
• Kelly Johnson Hoots, SLP
• Morgan House, M.A. CF-SLP

• All providers in Windsor, VA
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2007; 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.