Individual provider Active NPI

Alexandria Nicole Grigsby, LCDC

  • Counselor
  • Ben Wheeler, TX
National Provider Identifier
1720684012
Registry record updated Dec 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
15538 Issued in TX
Practice address
717 VZ CR 4701, Unit 102
Ben Wheeler, TX 75754
Phone
(903) 574-9162
NPI assigned
Dec 10, 2020
Last updated
Dec 10, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 15538 TX Primary

Addresses

Primary practice location

717 VZ CR 4701, Unit 102
Ben Wheeler, TX 75754

Mailing address

717 VZ CR 4701, Unit 102
Ben Wheeler, TX 75754
Phone (903) 574-9162

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
15538TXMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1720684012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "717 VZ CR 4701, UNIT 102",
            "city": "BEN WHEELER",
            "state": "TX",
            "postal_code": "75754",
            "telephone_number": "903-574-9162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "717 VZ CR 4701, UNIT 102",
            "city": "BEN WHEELER",
            "state": "TX",
            "postal_code": "75754",
            "telephone_number": "903-574-9162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIGSBY",
        "first_name": "ALEXANDRIA",
        "middle_name": "NICOLE",
        "credential": "LCDC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "TX",
            "license": "15538",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ben Wheeler, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.