Nicole M Grant, M. ED., LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

18777 Issued in TX

Practice address

2624 Kensington Dr Ste 112
Tyler, TX 75703-2734

Phone

(903) 530-2290

NPI assigned

Apr 11, 2013

Sex

Female

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

Opted out of Medicare

Yes, effective Mar 26, 2024 through Mar 26, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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.

• Remm Counseling PLLC

  • Counselor
  • Tyler, TX
  • NPI 1386404507
  NPD Authorized official

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

{
    "created_epoch": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1649613381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2624 KENSINGTON DR STE 112",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757032734",
            "telephone_number": "903-530-2290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2624 KENSINGTON DR STE 112",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757032734",
            "telephone_number": "903-530-2290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "NICOLE",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "M. ED., LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-04-11",
        "last_updated": "2021-08-19",
        "certification_date": "2020-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "18777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelsey Graham, PHARMD
• Thomas W Grahm, MD
• Kory Grammer
• Kristina Grandgeorge
• Jill Elizabeth Grant, DO
• Shanika Lanell Grant
• Shelley Grant
• Karin Elaine Grantham, APRN
• Dayna Graves
• Glen S Graves, MD

• Mental Health Counselor in Tyler, TX
• Providers in Tyler, TX by specialty
• Mental Health Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.