Active NPI
Kristina Grimm, MED, LPC
- Professional Counselor
- Wexford, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC014638
- Practice address
- 4001 Stonewood Dr Ste 110
Wexford, PA 15090-8398 - Phone
- (724) 747-1690
- Fax
- (412) 763-1235
- NPI assigned
- Jul 12, 2022
- Last updated
- Dec 29, 2023
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC014638 | PA | Primary |
Addresses
Primary practice location
4001 Stonewood Dr Ste 110
Wexford, PA 15090-8398
Mailing address
2727 Broadway Ave Apt 3
Pittsburgh, PA 15216-2143
Phone (814) 933-8100
Other practice location 1
1121 Boyce Rd Ste 2100
Pittsburgh, PA 15241-4020
Phone (814) 933-8100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4001 Stonewood Dr
Suite 110
Wexford, PA 15090-8398
Phone (412) 747-1690
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC014638 | PA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gesund Health LLC - MH Pittsburgh Management, a Protected Series | Current | Accepting new patients |
Locations
4001 Stonewood Dr
Ste 110
Wexford, PA 15090
Phone (412) 747-1690
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Ellie Mental Health Pittsburgh Management
- Mental Health Counselor
- Wexford, PA
- NPI 1063101145
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703808000000",
"number": "1417681735",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2727 BROADWAY AVE APT 3",
"city": "PITTSBURGH",
"state": "PA",
"postal_code": "152162143",
"telephone_number": "814-933-8100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4001 STONEWOOD DR STE 110",
"city": "WEXFORD",
"state": "PA",
"postal_code": "150908398",
"telephone_number": "724-747-1690",
"fax_number": "412-763-1235"
}
],
"practiceLocations": [
{
"address_1": "1121 Boyce Rd Ste 2100",
"address_purpose": "LOCATION",
"city": "Pittsburgh",
"state": "PA",
"postal_code": "152414020",
"country_code": "US",
"telephone_number": "814-933-8100",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRIMM",
"first_name": "KRISTINA",
"credential": "MED, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-07-12",
"last_updated": "2023-12-29",
"certification_date": "2023-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC014638",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Wexford, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.