Active NPI
Carolyn Grieve, LPMED
- Counseling Psychologist
- Grand Rapids, MN
National Provider Identifier
1396840955
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 1774
- Practice address
- 2618 Emerald Dr
Grand Rapids, MN 55744-5060 - Phone
- (218) 327-9013
- Fax
- (218) 327-9013
- NPI assigned
- Sep 14, 2006
- 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 |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 1774 | MN | Primary |
Addresses
Primary practice location
2618 Emerald Dr
Grand Rapids, MN 55744-5060
Mailing address
2618 Emerald Dr
Grand Rapids, MN 55744-5060
Phone (218) 327-9013
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6269079 | Other | MN | MEDICA |
| 8G812GR | Other | MN | BLUE CROSS BLUE SHIELD MN |
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 |
|---|---|---|---|
| 1774 | MN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lakeside Psychological Services | Counseling | 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.
-
- Counseling Psychologist
- Grand Rapids, MN
- NPI 1316043458
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158192000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1396840955",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2618 EMERALD DR",
"city": "GRAND RAPIDS",
"state": "MN",
"postal_code": "557445060",
"telephone_number": "218-327-9013",
"fax_number": "218-327-9013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2618 EMERALD DR",
"city": "GRAND RAPIDS",
"state": "MN",
"postal_code": "557445060",
"telephone_number": "218-327-9013",
"fax_number": "218-327-9013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRIEVE",
"first_name": "CAROLYN",
"credential": "LPMED",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-14",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "MN",
"license": "1774",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICA",
"identifier": "6269079",
"state": "MN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD MN",
"identifier": "8G812GR",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Grand Rapids, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.