Individual provider Active NPI

Grant Thomas Gilliam, LMHC

  • Mental Health Counselor
  • Bloomington, IN
National Provider Identifier
1730659301
Registry record updated Sep 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39003932A Issued in IN
Practice address
550 S Adams St
Bloomington, IN 47403-2165
Phone
(812) 333-6324
Fax
(812) 331-6700
NPI assigned
Nov 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 39003932A IN Primary

Addresses

Primary practice location

550 S Adams St
Bloomington, IN 47403-2165

Mailing address

550 S Adams St
Bloomington, IN 47403-2165
Phone (812) 333-6324

Other practice location 1

645 S Rogers St
Bloomington, IN 47403-2353
Phone (812) 339-1691

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20231129002338 IN Practitioner - Mental Health Counselor 0749638872 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Stone Belt Arc, Inc.Group PAC ID 8820900111, 7 clinicians
Centerstone of Indiana IncGroup PAC ID 9436138427, 114 clinicians

Practice addresses (Care Compare)

550 S Adams St
Bloomington, IN 47403-2165
Phone (812) 333-6324

645 S Rogers St
Bloomington, IN 47403-2353
Phone (812) 339-1691

720 N Marr Rd
Columbus, IN 47201-6660
Phone (812) 314-3400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stone Belt Arc, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Centerstone of Indiana, Inc. CurrentSince Sep 2, 2025 Accepting new patients
Centerstone of Indiana, Inc. CurrentSince Sep 2, 2025 Accepting new patients

Locations

645 S Rogers St
Bloomington, IN 47403
Phone (812) 339-1691

2815 E 10th St
Bloomington, IN 47408
Phone (812) 332-2168

550 S Adams St
Bloomington, IN 47403
Phone (812) 333-6324

720 N Marr Rd
Columbus, IN 47201
Phone (812) 314-3400

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1543276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757980800000",
    "number": "1730659301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 S ADAMS ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032165",
            "telephone_number": "812-333-6324",
            "fax_number": "812-331-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 S ADAMS ST",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032165",
            "telephone_number": "812-333-6324",
            "fax_number": "812-331-6700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "645 S ROGERS ST",
            "address_purpose": "LOCATION",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474032353",
            "country_code": "US",
            "telephone_number": "812-339-1691",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "GRANT",
        "middle_name": "THOMAS",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-27",
        "last_updated": "2025-09-16",
        "certification_date": "2025-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39003932A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

Verify at the official NPI Registry.