Individual provider Active NPI

Colleen Grunhaus, LPC

  • Professional Counselor
  • Hampton, VA
National Provider Identifier
1689081036
Registry record updated Jul 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
0701005854 Issued in VA
Practice address
600 Medical Dr
Ste a & B
Hampton, VA 23666-1769
Phone
(757) 788-0600
Fax
(757) 788-0969
NPI assigned
Jul 17, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 0701005854 VA Primary

Addresses

Primary practice location

600 Medical Dr
Ste a & B
Hampton, VA 23666-1769

Mailing address

300 Medical Dr
Hampton, VA 23666-1765
Phone (757) 788-0300

Other identifiers 1

IdentifierTypeStateIssuer
1659424448MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0701005854VAMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1405555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405555200000",
    "number": "1689081036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MEDICAL DR",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236661765",
            "telephone_number": "757-788-0300",
            "fax_number": "757-788-0969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 MEDICAL DR",
            "address_2": "STE A & B",
            "city": "HAMPTON",
            "state": "VA",
            "postal_code": "236661769",
            "telephone_number": "757-788-0600",
            "fax_number": "757-788-0969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUNHAUS",
        "first_name": "COLLEEN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-17",
        "last_updated": "2014-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "VA",
            "license": "0701005854",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1659424448",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2014; 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.