Individual provider Active NPI

Amy Grubbs, LPC PLLC

  • Professional Counselor
  • Mansfield, TX
National Provider Identifier
1730527417
Registry record updated Aug 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
67863 Issued in TX
Practice address
602 Strada Cir
Mansfield, TX 76063-3201
Phone
(817) 320-8091
NPI assigned
Jun 4, 2013
Last updated
Aug 30, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2023

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 67863 TX Primary

Addresses

Primary practice location

602 Strada Cir
Mansfield, TX 76063-3201

Mailing address

1020 Kingston Dr
Mansfield, TX 76063-2660
Phone (817) 320-8091

Other names 1

  • Amy Martini Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20241015001204 TX Practitioner - Mental Health Counselor 7618409749 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Amy Grubbs LPC PLLC CurrentSince Sep 2, 2024 Accepting new patients

Locations

602 Strada Cir
Mansfield, TX 76063
Phone (469) 563-2941

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1370304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1730527417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 KINGSTON DR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760632660",
            "telephone_number": "817-320-8091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 STRADA CIR",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760633201",
            "telephone_number": "817-320-8091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRUBBS",
        "first_name": "AMY",
        "credential": "LPC PLLC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-06-04",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "67863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "MARTINI",
            "credential": "LPC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.