Individual provider Active NPI

Tiaisha-Nicol Grant, MHC

  • Mental Health Counselor
  • Valley Stream, NY
National Provider Identifier
1942083050
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
108 S Franklin Ave Ste 3
Valley Stream, NY 11580-6105
Phone
(516) 303-9925
NPI assigned
Aug 14, 2023
Last updated
Aug 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NU Primary

Addresses

Primary practice location

108 S Franklin Ave Ste 3
Valley Stream, NY 11580-6105

Mailing address

95 Palmetto St Apt 3a
Brooklyn, NY 11221-4950
Phone (347) 204-9466

Other practice location 1

95 Palmetto St Apt 3A
Brooklyn, NY 11221-4950
Phone (347) 204-9466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1942083050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95 PALMETTO ST APT 3A",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112214950",
            "telephone_number": "347-204-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 S FRANKLIN AVE STE 3",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115806105",
            "telephone_number": "516-303-9925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "95 Palmetto St Apt 3A",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112214950",
            "country_code": "US",
            "telephone_number": "347-204-9466",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRANT",
        "first_name": "TIAISHA-NICOL",
        "credential": "MHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valley Stream, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.