Active NPI
Stephen Roger Grams, MA
- Addiction (Substance Use Disorder) Counselor
- Mesa, AZ
National Provider Identifier
1417455395
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- LISAC-1405
- Practice address
- 1830 S Alma School Rd Ste 101
Mesa, AZ 85210-3086 - Phone
- (480) 649-3352
- NPI assigned
- Jan 25, 2018
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | LISAC-1405 | AZ | Primary |
Addresses
Primary practice location
1830 S Alma School Rd Ste 101
Mesa, AZ 85210-3086
Mailing address
1830 S Alma School Rd Ste 101
Mesa, AZ 85210-3086
Phone (480) 649-3352
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LISAC-1405 | AZ | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516838400000",
"number": "1417455395",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1830 S ALMA SCHOOL RD STE 101",
"city": "MESA",
"state": "AZ",
"postal_code": "852103086",
"telephone_number": "480-649-3352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1830 S ALMA SCHOOL RD STE 101",
"city": "MESA",
"state": "AZ",
"postal_code": "852103086",
"telephone_number": "480-649-3352"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAMS",
"first_name": "STEPHEN",
"middle_name": "ROGER",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-01-25",
"last_updated": "2018-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "AZ",
"license": "LISAC-1405",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mesa, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.