Active NPI
Amanda Grzadzielewski
- Rehabilitation Counselor
- Crookston, MN
National Provider Identifier
1447998703
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rehabilitation Counselor
- Practice address
- 603 Bruce St
Crookston, MN 56716-2914 - Phone
- (218) 281-3940
- NPI assigned
- May 25, 2022
- Last updated
- May 25, 2022
- 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 |
|---|---|---|---|---|
| Rehabilitation Counselor | 225C00000X | NU | Primary |
Addresses
Primary practice location
603 Bruce St
Crookston, MN 56716-2914
Mailing address
16668 160TH St NE
Thief River Falls, MN 56701-8482
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | CredibleBH.com | Health Information Exchange (HIE) |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1653436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653436800000",
"number": "1447998703",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16668 160TH ST NE",
"city": "THIEF RIVER FALLS",
"state": "MN",
"postal_code": "567018482"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "603 BRUCE ST",
"city": "CROOKSTON",
"state": "MN",
"postal_code": "567162914",
"telephone_number": "218-281-3940"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRZADZIELEWSKI",
"first_name": "AMANDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-05-25",
"last_updated": "2022-05-25",
"certification_date": "2022-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "225C00000X",
"taxonomy_group": "",
"desc": "Rehabilitation Counselor",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "CredibleBH.com",
"affiliation": "N",
"endpointDescription": "onlineHIE E",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "603 Bruce St",
"city": "Crookston",
"state": "MN",
"country_code": "US",
"postal_code": "567162914",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Crookston, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.