Tiffany Marie Thayer Grant, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

15733 Issued in MN

Practice address

2550 University Ave W
Suite 229N
Saint Paul, MN 55114-1052

Phone

(651) 645-3115

Fax

(651) 645-2752

NPI assigned

Sep 26, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Psych Recovery IncGroup PAC ID 3779633912, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Psych Recovery Inc

  • Psychiatry Physician
  • Saint Paul, MN
  • NPI 1316189541

  Clinical

  Medicare reassignment Care Compare group NPD
• Psychiatric Recovery PA

  • Adolescent and Children Mental Health Clinic/Center
  • Saint Paul, MN
  • NPI 1891713681
  NPD (past)

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338940800000",
    "number": "1467553230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 BIRNAMWOOD DR",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "553376812",
            "telephone_number": "612-273-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W",
            "address_2": "SUITE 229N",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141052",
            "telephone_number": "651-645-3115",
            "fax_number": "651-645-2752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "TIFFANY",
        "middle_name": "MARIE THAYER",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2012-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "15733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218630600",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRACTICE FED TAX ID#",
            "identifier": "41-1576550",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer Rose Granlund, P.T.
• Gregory Allen Granrud, M.D.
• Grant Booth PA Dba Booth Therapy
• McKenzie Grant, BSN, RN
• Melissa Aline Grant, PA-C
• Christianna Gratz Carlin, PT
• Thomas G Gratzer, MD
• Patrick C Graupman, MD
• Matthew D Gravel, D.C.
• Krista K Graven, MD

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; 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.

Verify at the official NPI Registry.