Nakisha Lavon Grant

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

98955 Issued in CA

Practice address

31772 Casino Dr Ste a&B
Lake Elsinore, CA 92530-4502

Phone

(951) 674-9400

Fax

(951) 674-9486

NPI assigned

Jul 15, 2019

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

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

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 Partners

  • Mental Health Counselor
  • Temecula, CA
  • NPI 1811455306
  Medicare reassignment NPD
• Psychology Partners a Prof Corp

  dba Psych Partners

  • Marriage & Family Therapist
  • Temecula, CA
  • NPI 1104797398
  NPD (past)

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

{
    "created_epoch": "1563148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563148800000",
    "number": "1538711049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31772 CASINO DR STE A&B",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304502",
            "telephone_number": "951-674-9400",
            "fax_number": "951-674-9486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31772 CASINO DR STE A&B",
            "city": "LAKE ELSINORE",
            "state": "CA",
            "postal_code": "925304502",
            "telephone_number": "951-674-9400",
            "fax_number": "951-674-9486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "NAKISHA",
        "middle_name": "LAVON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-15",
        "last_updated": "2019-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "98955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Giselle Grajeda
• Grand Terrace Detox and Recovery
• Philip Grande, LMFT
• Savannah Granic
• Felene Grant, MA
• Amber Deneen Gray, PHD, DBH, CDVC, CVIS
• Dale Allen Green Jr.
• Miriam Green
• Melissa J Greenberg
• Marie-Christine Greene, MFT -I

• Mental Health Counselor in Lake Elsinore, CA
• Providers in Lake Elsinore, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.