Grand Mesa Therapy Washington PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

GRAND MESA THERAPY WASHINGTON PLLC

Practice address

610 S 12TH St
Bismarck, ND 58504-5910

Phone

(970) 787-5100

Fax

(970) 787-5100

NPI assigned

May 29, 2026

Organization subpart

No

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

Authorized official

Name

Holly Shockley

Title

Owner

Phone

(970) 787-5100

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1780012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1783555200000",
    "number": "1881526556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 S 12TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 S 12TH ST",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585045910",
            "telephone_number": "970-787-5100",
            "fax_number": "970-787-5100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1500 N Grant St Ste R",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802031859",
            "country_code": "US",
            "telephone_number": "970-787-5100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5900 Balcones Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787314298",
            "country_code": "US",
            "telephone_number": "970-787-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "GRAND MESA THERAPY WASHINGTON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-29",
        "last_updated": "2026-07-09",
        "certification_date": "2026-07-09",
        "status": "A",
        "authorized_official_last_name": "SHOCKLEY",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "970-787-5100"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2026; 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.