Individual provider Active NPI

Jasminka Hasan Grgas, LPC

  • Professional Counselor
  • Willimantic, CT
National Provider Identifier
1831258854
Registry record updated Jan 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
1310 Main St
Willimantic, CT 06226-1910
Phone
(860) 731-5522
Fax
(860) 731-5536
NPI assigned
Dec 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 19285 TX
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

1310 Main St
Willimantic, CT 06226-1910

Mailing address

2 Waterside Xing Ste 401
Windsor, CT 06095-1588
Phone (860) 731-5522

Other practice location 1

7011 Southwest Fwy
Houston, TX 77074-2007
Phone (713) 970-7000

Other identifiers 1

IdentifierTypeStateIssuer
170734101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240129003665 CT Practitioner - Mental Health Counselor 2365895018 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006700CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Resources, Inc. CurrentSince Jan 1, 2024 Accepting new patients
The Harris Center for Mental Health and Idd PastSince Oct 30, 2000 Accepting new patients

Locations

153 Hazard Ave
Enfield, CT 06082
Phone (860) 253-5020

1310 Main St
Willimantic, CT 06226
Phone (860) 456-0038

2 Waterside Xing
Ste 401
Windsor, CT 06095

Organizations & group practices 2

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": "1165363200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705104000000",
    "number": "1831258854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 WATERSIDE XING STE 401",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060951588",
            "telephone_number": "860-731-5522",
            "fax_number": "860-731-5536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 MAIN ST",
            "city": "WILLIMANTIC",
            "state": "CT",
            "postal_code": "062261910",
            "telephone_number": "860-731-5522",
            "fax_number": "860-731-5536"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7011 Southwest Fwy",
            "address_purpose": "LOCATION",
            "city": "Houston",
            "state": "TX",
            "postal_code": "770742007",
            "country_code": "US",
            "telephone_number": "713-970-7000",
            "fax_number": "713-970-7246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRGAS",
        "first_name": "JASMINKA",
        "middle_name": "HASAN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-06",
        "last_updated": "2024-01-13",
        "certification_date": "2024-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "19285",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170734101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willimantic, CT

Sources for this page

Verify at the official NPI Registry.