Grizelli-Shane Padamada, LPCC 9228

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPCC9228 Issued in CA

Practice address

5706 Baltimore Dr Unit 375
La Mesa, CA 91942-1685

Phone

(619) 567-7399

NPI assigned

Feb 18, 2015

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Miss Shane Padamada Professional name

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.

• Fusion Care Group, a Psychological Professional Corporation

  • Clinical Psychologist
  • Alpine, CA
  • NPI 1275177982
  Medicare reassignment NPD
• Achieve Your True Potential

  • Marriage & Family Therapist
  • San Diego, CA
  • NPI 1356792626

  Mental Health

  NPD (past)

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

{
    "created_epoch": "1424217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1679965206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5706 BALTIMORE DR UNIT 375",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421685",
            "telephone_number": "909-831-5887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5706 BALTIMORE DR UNIT 375",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919421685",
            "telephone_number": "619-567-7399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADAMADA",
        "first_name": "GRIZELLI-SHANE",
        "name_prefix": "Miss",
        "credential": "LPCC 9228",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-18",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CA",
            "license": "LPCC9228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SHANE",
            "last_name": "PADAMADA",
            "prefix": "MISS",
            "credential": "LPCC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• P Thomas Hiser DDS Ms Inc
• Arielle Paamoni, PA-C
• Paband Medical Corp
• Rashid Paband, M.D.
• Pacific Arrhythmia Services Inc
• Vanessa Padron
• Yenisleidy Paez Perez, DO
• Nita Paintal, MD
• Melanie Purificacion Pajimula, CPHT
• Anngela Palacio

• Professional Counselor in La Mesa, CA
• Providers in La Mesa, CA by specialty
• Professional Counselor in California

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