Active NPI
Shani Lane Grant, M.ED, LPC
- Counselor
- Fort Worth, TX
National Provider Identifier
1396373767
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 79827
- Practice address
- 4545 Bellaire Dr S Ste 6
Fort Worth, TX 76109-1811 - Phone
- (817) 657-1115
- NPI assigned
- Mar 31, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 79827 | TX | Primary |
Addresses
Primary practice location
4545 Bellaire Dr S Ste 6
Fort Worth, TX 76109-1811
Mailing address
4545 Bellaire Dr S Ste 6
Fort Worth, TX 76109-1811
Phone (817) 657-1115
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
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 79827 | TX | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Counseling by Penny | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Professional Counselor
- Granbury, TX
- NPI 1053723551
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1585612800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1585612800000",
"number": "1396373767",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4545 BELLAIRE DR S STE 6",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761091811",
"telephone_number": "817-657-1115"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4545 BELLAIRE DR S STE 6",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761091811",
"telephone_number": "817-657-1115"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "SHANI",
"middle_name": "LANE",
"credential": "M.ED, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-31",
"last_updated": "2020-03-31",
"certification_date": "2020-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "TX",
"license": "79827",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.