Active NPI
Deborah Granick, LCSW, RN, PMHNP
- Psychiatric/Mental Health Nurse Practitioner
- Raleigh, NC
National Provider Identifier
1790059103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- 5009850
- Practice address
- 1001 Navajo
Raleigh, NC 27609 - Phone
- (919) 856-4703
- NPI assigned
- Mar 2, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| CO10514 | NC | MD | Clinical Social Worker |
| 2010004568 | MO | MD | Community Health Registered Nurse |
| 5009850 | NC | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New 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.
-
dba Common Ground Psychiatry
- Psychiatric/Mental Health Nurse Practitioner
- Huntersville, NC
- NPI 1902417488
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.