Individual provider Active NPI

Deborah Granick, LCSW, RN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1790059103
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5009850 Issued in NC
Practice address
1001 Navajo
Raleigh, NC 27609
Phone
(919) 856-4703
NPI assigned
Mar 2, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CO10514 NC
Clinical Social Worker 1041C0700X 2010012064 MO
Community Health Registered Nurse 163WC1500X 2010004568 MO
Community Health Registered Nurse 163WC1500X 293967 NC
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5009850 NC Primary

Addresses

Primary practice location

1001 Navajo
Raleigh, NC 27609

Mailing address

5116 Terra Cotta Dr
Raleigh, NC 27613-6254
Phone (314) 413-1391

Other practice location 1

1013 Bullard Ct # 102
Raleigh, NC 27615-6801
Phone (919) 868-6508

Other practice location 2

12740 Spruce Tree Way Ste 102
Raleigh, NC 27614-8295
Phone (314) 413-1391

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)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
CO10514NCMDClinical Social Worker
2010004568MOMDCommunity Health Registered Nurse
5009850NCMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Erin Klender PLLC Psychiatric/Mental Health Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1790059103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5116 TERRA COTTA DR",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276136254",
            "telephone_number": "314-413-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 NAVAJO",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27609",
            "telephone_number": "919-856-4703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1013 Bullard Ct # 102",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276156801",
            "country_code": "US",
            "telephone_number": "919-868-6508",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12740 Spruce Tree Way Ste 102",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "276148295",
            "country_code": "US",
            "telephone_number": "314-413-1391",
            "fax_number": "919-916-1160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANICK",
        "first_name": "DEBORAH",
        "credential": "LCSW, RN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "CO10514",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2010012064",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "MO",
            "license": "2010004568",
            "primary": false
        },
        {
            "code": "163WC1500X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Community Health",
            "state": "NC",
            "license": "293967",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5009850",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.