Equip Christian Counseling, PLLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

Legal business name

EQUIP CHRISTIAN COUNSELING, PLLC

Practice address

917 N Walnut St Ste 101-15
Danville, IL 61832-3911

Phone

(770) 515-8835

NPI assigned

Aug 1, 2024

Organization subpart

No

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

Authorized official

Name

Mrs. Tracy Grissom, MANPI 1326268814

Title

LCPC

Phone

(770) 515-8835

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tracy F. Grissom, MA

  • Professional Counselor
  • Urbana, IL
  • NPI 1326268814
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1722470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722470400000",
    "number": "1861221392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 N WALNUT ST STE 101-15",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618323911",
            "telephone_number": "770-515-8835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 N WALNUT ST STE 101-15",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618323911",
            "telephone_number": "770-515-8835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUIP CHRISTIAN COUNSELING, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-01",
        "last_updated": "2024-08-01",
        "certification_date": "2024-07-31",
        "status": "A",
        "authorized_official_last_name": "GRISSOM",
        "authorized_official_first_name": "TRACY",
        "authorized_official_title_or_position": "LCPC",
        "authorized_official_telephone_number": "770-515-8835",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Marie Elliott, D.C.
• Mickensy Leigh Ellis-White, MS, LCPC, NCC, MAC
• Jordan Michael Ellis, DMD
• Empowered Communication LLC
• Brittney Enos
• Stephanie Ericksen, PHD
• Kelly Jo Erke, APRN
• Adrian Ervington, PSYD
• Jeanne Elizabeth Esmann, BSW
• Darlene L Etter, L.C.S.W

• Professional Counselor in Danville, IL
• Providers in Danville, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.