MRS. DONNA S. GRISHAM (LADC) – Addiction (Substance Use Disorder) Counselor, NPI 1508804352

MRS. DONNA S. GRISHAM (LADC) is a healthcare provider. based in Portland, Connecticut. specializing in Addiction (Substance Use Disorder) Counselor. They hold the professional credentials LADC. They hold a License No. 000424 (CT). The NPI Number for MRS. DONNA S. GRISHAM (LADC) is 1508804352

Main info

Female
Sole Proprietor
15 Years Of Experience
Accepts Medicare Assignment
Name
MRS. DONNA S. GRISHAM (LADC)
NPI
1508804352
Phone
(860) 342-0760
Address
553 PORTLAND COBALT RD
Enumeration Date
3 June 2006
Last Update Date
14 July 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2032395321500
Graduation Year
2011 (15 years ago)
PAC ID
7719128560
Group Practice PAC ID
5799784922
Professional Enrollment ID
I20130722000184
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for MRS. DONNA S. GRISHAM (LADC)

  • 553, Portland-Cobalt Road, Portland, Middlesex County, Connecticut, 06480, United States

    PORTLAND, CT 064801968

    Phone: (860) 342-0760

    Fax: (860) 342-4226

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2013-07-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20130722000184IClinical Social WorkerCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06480)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5799784922View full group profile
NameSpecialtyState
-CT
Clinical Social WorkerCT
Clinical Social WorkerCT
Nurse PractitionerCT
Nurse PractitionerCT

Reviews

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Frequently asked questions

What is the standard ID for MRS. DONNA S. GRISHAM (LADC) in the U.S.?
In the U.S., MRS. DONNA S. GRISHAM (LADC) is identified by NPI 1508804352.
Is MRS. DONNA S. GRISHAM (LADC) currently accepting referrals based on NPI status?
Registry metadata lists MRS. DONNA S. GRISHAM (LADC) as active.
How should patients interpret MRS. DONNA S. GRISHAM (LADC)'s specialty?
The extract shows Addiction (Substance Use Disorder) Counselor for MRS. DONNA S. GRISHAM (LADC). Clinical services aligned with this taxonomy classification.
What city is tied to MRS. DONNA S. GRISHAM (LADC)?
The directory associates MRS. DONNA S. GRISHAM (LADC) with Portland, Connecticut. Check all listed addresses for suites or satellite offices.
Who maintains MRS. DONNA S. GRISHAM (LADC)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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