Cynthia A Grajkowski, MS ED LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

693124 Issued in WI

Practice address

2217 Vine St
Suite 206
Hudson, WI 54016-5863

Phone

(715) 441-1828

Fax

(888) 802-9673

NPI assigned

Aug 21, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Feb 9, 2024 through Feb 9, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Couples & Family Therapy Center, LLC

  • Marriage & Family Therapist
  • Hudson, WI
  • NPI 1073747804
  NPD

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1861508343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2217 VINE ST",
            "address_2": "SUITE 206",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540165863",
            "telephone_number": "715-441-1828",
            "fax_number": "888-802-9673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2217 VINE ST",
            "address_2": "SUITE 206",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540165863",
            "telephone_number": "715-441-1828",
            "fax_number": "888-802-9673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAJKOWSKI",
        "first_name": "CYNTHIA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "MS ED LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "WI",
            "license": "693124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Hudson, WI
• Providers in Hudson, WI by specialty
• Marriage & Family Therapist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.