Individual provider Active NPI

Jacob Grunhut

  • Clinical Child & Adolescent Psychologist
  • Scottsdale, AZ
National Provider Identifier
1407579758
Registry record updated Sep 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
Practice address
13210 N 72ND PL
Scottsdale, AZ 85260-3900
Phone
(845) 825-3606
NPI assigned
Sep 21, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X Primary

Addresses

Primary practice location

13210 N 72ND PL
Scottsdale, AZ 85260-3900

Mailing address

13210 N 72ND PL
Scottsdale, AZ 85260-3900
Phone (845) 825-3606

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL uniquelifeskills@gmail.com Direct

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

Practice roles

OrganizationSpecialtyStatusNew patients
Unique Life Skills, LLC Clinical Child & Adolescent CurrentSince Oct 1, 2022 Accepting new patients
Unique Life Skills Az, LLC CurrentSince Jan 29, 2023 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1407579758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13210 N 72ND PL",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603900",
            "telephone_number": "845-825-3606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13210 N 72ND PL",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852603900",
            "telephone_number": "845-825-3606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNHUT",
        "first_name": "JACOB",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-21",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "uniquelifeskills@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "13210 N 72nd Pl",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852603900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.