Individual provider Active NPI

Holly Cramblet

  • Counseling Psychologist
  • Grand Rapids, MI
National Provider Identifier
1821419912
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
6361002922 Issued in MI
Practice address
1490 E Beltline Ave SE
Grand Rapids, MI 49506-4336
Phone
(616) 940-0040
NPI assigned
Dec 17, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 6361002922 MI
Behavior Analyst 103K00000X
Psychologist 103T00000X 6361002922 MI
Counseling Psychologist 103TC1900X 6361002922 MI Primary

Addresses

Primary practice location

1490 E Beltline Ave SE
Grand Rapids, MI 49506-4336

Mailing address

1490 E Beltline Ave SE
Grand Rapids, MI 49506-4336
Phone (616) 940-0040

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rockford Speech Therapy, LLC 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": "1387238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1821419912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1490 E BELTLINE AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495064336",
            "telephone_number": "616-940-0040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1490 E BELTLINE AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495064336",
            "telephone_number": "616-940-0040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRAMBLET",
        "first_name": "HOLLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-17",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "MI",
            "license": "6361002922",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6361002922",
            "primary": false
        },
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6361002922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 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.