Jared Grob, MA

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LPCCANDIDATE11561 Issued in OK

Practice address

13707 Fairhill Ave
Edmond, OK 73013-1946

Phone

(405) 607-4041

Fax

(405) 463-0090

NPI assigned

Jun 27, 2023

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/13010/brand/1/csg/1/fhir/r4

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.

• Pathways Medical LLC

  • Primary Care Clinic/Center
  • Edmond, OK
  • NPI 1194185090
  NPD
• Pathways Professional Counseling LLC

  • Community/Behavioral Health Agency
  • Oklahoma City, OK
  • NPI 1043392558
  NPD

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1558047027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13707 FAIRHILL AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131946",
            "telephone_number": "405-607-4041",
            "fax_number": "405-463-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13707 FAIRHILL AVE",
            "city": "EDMOND",
            "state": "OK",
            "postal_code": "730131946",
            "telephone_number": "405-607-4041",
            "fax_number": "405-463-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROB",
        "first_name": "JARED",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OK",
            "license": "LPCCANDIDATE11561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tessia Griffith
• Grimmett Ventures, Inc.
• Michael B Grindstaff, OD
• Willie Grissom
• Sarah Gritts
• Lillianne Grob
• Lisa Grossenbacher, LCSW
• Roger Grosz, B.S.
• Sheila J Groves, MS, RD/LD
• Lauren Grubb, CCC-SLP

• All providers in Edmond, OK
• Mental Health Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.