Individual provider Active NPI

Lea Rae Grosvenor, LCDC III

  • Professional Counselor
  • Fairfield, OH
National Provider Identifier
1467968735
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC-23977 Issued in AZ
Practice address
5108 Sandy LN
Fairfield, OH 45014-2738
Phone
(513) 834-7063
Fax
(513) 873-1567
NPI assigned
Dec 21, 2017
Last updated
Jan 6, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X LCDCIII.141046 OH
Professional Counselor 101YP2500X LPC-23977 AZ Primary

Addresses

Primary practice location

5108 Sandy LN
Fairfield, OH 45014-2738

Mailing address

615 Elsinore PL Ste 300
Cincinnati, OH 45202-1475
Phone (513) 834-7063

Other names 1

  • Lea Rae Middleton Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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

Enrollment IDStateProvider typePAC IDDetails
I20260122003295 AZ Practitioner - Mental Health Counselor 7113404971

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1313 N 2ND St
Apt 1432
Phoenix, AZ 85004-1771

1702 E Bell Rd
Phoenix, AZ 85022-6273

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCDCIII.141046OHMDAddiction (Substance Use Disorder) Counselor
LPC-23977AZMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cornerstone Healing Center, LLC Addiction (Substance Use Disorder) CurrentSince Dec 6, 2025 Accepting new patients
Cornerstone Healing Center, LLC CurrentSince Dec 6, 2025 Accepting new patients
L&J Healthcare, LLC PastSince Feb 1, 2019 Accepting new patients
Cornerstone Healing Center, LLC Past Accepting new patients
L&J Healthcare Dba Adams Recovery Center, LLC Past Accepting new patients

Locations

4344 W Indian School Rd
Ste 22
Phoenix, AZ 85031
Phone (800) 480-1781

4344 W Indian School Rd
Ste 2223
Phoenix, AZ 85031
Phone (480) 863-0217

4344 W Indian School Rd
Ste 2322
Phoenix, AZ 85031

16444 N 91st St
Scottsdale, AZ 85260
Phone (480) 863-0217

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1513814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1467968735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 ELSINORE PL STE 300",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452021475",
            "telephone_number": "513-834-7063",
            "fax_number": "513-873-1567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5108 SANDY LN",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450142738",
            "telephone_number": "513-834-7063",
            "fax_number": "513-873-1567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSVENOR",
        "first_name": "LEA",
        "middle_name": "RAE",
        "name_prefix": "Mrs.",
        "credential": "LCDC III",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-21",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LCDCIII.141046",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "AZ",
            "license": "LPC-23977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEA",
            "last_name": "MIDDLETON",
            "middle_name": "RAE",
            "credential": "LCDC III",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.