Jaclyn Grelle, ED.S.

Primary specialty

School PsychologistTaxonomy code 103TS0200X

License

10140084 Issued in IN

Practice address

6740 W Morris St
Indianapolis, IN 46241-1719

Phone

(317) 988-8082

NPI assigned

Oct 29, 2024

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

Other names 1

• Jackie Grelle Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1730160000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1679395883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6861 WALNUT BEND RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462545233",
            "telephone_number": "317-650-2263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6740 W MORRIS ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462411719",
            "telephone_number": "317-988-8082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1643 Dunlap Ave",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462413915",
            "country_code": "US",
            "telephone_number": "317-988-6676",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRELLE",
        "first_name": "JACLYN",
        "credential": "ED.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-29",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "IN",
            "license": "10140084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "GRELLE",
            "credential": "ED.S.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rachelle Grace C Greist, MD
• Thomas H Greist, M.D.
• Nicole K Greives, NP
• Laura Greiwe
• Eve Nicole Grelle, O.D.
• Stacie Gren, RN
• Kelsey Lynne Grennell, PA-C
• Emily Grese, LCSW
• Caroline Elise Gretencord
• Chad W Gretencord, CST, CFA

• School Psychologist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• School Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2024; 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.