Active NPI
Shane Griggs, LPC
- Professional Counselor
- Pocatello, ID
National Provider Identifier
1386197739
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC-6279
- Practice address
- 1352 E Center St Ste a
Pocatello, ID 83201-4773 - Phone
- (208) 233-2025
- Fax
- (208) 233-2178
- NPI assigned
- Aug 2, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-6279 | ID | Primary |
Addresses
Primary practice location
1352 E Center St Ste a
Pocatello, ID 83201-4773
Mailing address
28 Willowood Ave
Pocatello, ID 83204-4004
Phone (208) 241-8207
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-6279 | ID | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470096000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470096000000",
"number": "1386197739",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "28 WILLOWOOD AVE",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832044004",
"telephone_number": "208-241-8207",
"fax_number": "208-233-2178"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1352 E CENTER ST STE A",
"city": "POCATELLO",
"state": "ID",
"postal_code": "832014773",
"telephone_number": "208-233-2025",
"fax_number": "208-233-2178"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIGGS",
"first_name": "SHANE",
"credential": "LPC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-02",
"last_updated": "2016-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "ID",
"license": "LPC-6279",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pocatello, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.