Active NPI
Kristen Grubbs, LPC
- Mental Health Counselor
- Conway, AR
National Provider Identifier
1538367891
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- P0909061
- Practice address
- 2215 E Oak St Ste 1
Conway, AR 72032-4644 - Phone
- (501) 336-0511
- Fax
- (501) 336-4037
- NPI assigned
- Jul 10, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | P0909061 | AR | Primary |
Addresses
Primary practice location
2215 E Oak St Ste 1
Conway, AR 72032-4644
Mailing address
2215 E Oak St Ste 1
Conway, AR 72032-4644
Phone (501) 336-0511
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P0909061 | AR | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Coco Psychiatric Services PLLC | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Little Rock, AR
- NPI 1326647918
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490832000000",
"number": "1538367891",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2215 E OAK ST STE 1",
"city": "CONWAY",
"state": "AR",
"postal_code": "720324644",
"telephone_number": "501-336-0511",
"fax_number": "501-336-4037"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2215 E OAK ST STE 1",
"city": "CONWAY",
"state": "AR",
"postal_code": "720324644",
"telephone_number": "501-336-0511",
"fax_number": "501-336-4037"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRUBBS",
"first_name": "KRISTEN",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-10",
"last_updated": "2017-03-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AR",
"license": "P0909061",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conway, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.