Individual provider Active NPI

Monica Denise Grambusch, MA, LCMHCS, LCAS

  • Counselor
  • Fayetteville, NC
National Provider Identifier
1922497379
Registry record updated Jun 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
A11238 Issued in NC
Practice address
804 Stamper Rd
Suite 101
Fayetteville, NC 28303-4379
Phone
(910) 323-2875
Fax
(910) 323-1355
NPI assigned
Jan 22, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X A11238 NC Primary

Addresses

Primary practice location

804 Stamper Rd
Suite 101
Fayetteville, NC 28303-4379

Mailing address

231 Meed CT Ste 201
Fayetteville, NC 28303-2076
Phone (919) 636-5240

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20231213003650 NC Practitioner - Mental Health Counselor 1850740077 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
A11238NCMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of North Carolina, PC Current Accepting new patients
Optum Behavioral Care of North Carolina, P.C. CurrentSince Feb 27, 2024 Accepting new patients
Optum Behavioral Care of North Carolina, PC CurrentSince Feb 27, 2024 Accepting new patients
On the Road Again, Inc. PastSince Nov 20, 2022 Accepting new patients
Raintree Clinic Past Accepting new patients

Locations

1101 Marco Dr
Ste 200
Apex, NC 27502
Phone (844) 534-7202

2 Walden Ridge Dr
Ste 80
Asheville, NC 28803
Phone (828) 708-5274

7400 Carmel Executive Park Dr
Ste 155
Charlotte, NC 28226
Phone (844) 534-7208

231 Meed Ct
Ste 201
Fayetteville, NC 28303
Phone (828) 232-8934

Organizations & group practices 5

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": "1421884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719532800000",
    "number": "1922497379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 MEED CT STE 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283032076",
            "telephone_number": "919-636-5240",
            "fax_number": "910-323-1355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 STAMPER RD",
            "address_2": "SUITE 101",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283034379",
            "telephone_number": "910-323-2875",
            "fax_number": "910-323-1355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAMBUSCH",
        "first_name": "MONICA",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "MA, LCMHCS, LCAS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-22",
        "last_updated": "2024-06-28",
        "certification_date": "2024-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "A11238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

Verify at the official NPI Registry.