ELLEN MIRIAM GRUNBLATT (MD, LCPC) – Professional Counselor, NPI 1114019759

ELLEN MIRIAM GRUNBLATT (MD, LCPC) is a healthcare provider. based in Farmington, Maine. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials MD, LCPC. They hold a License No. XL3022 (ME). The NPI Number for ELLEN MIRIAM GRUNBLATT (MD, LCPC) is 1114019759

Main info

Female
Sole Proprietor
20 Years Of Experience
Accepts Medicare Assignment
Name
ELLEN MIRIAM GRUNBLATT (MD, LCPC)
NPI
1114019759
Phone
(207) 778-5792
Address
672 WILTON RD
Enumeration Date
29 September 2006
Last Update Date
6 April 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2077789531
Graduation Year
2006 (20 years ago)
PAC ID
5294832820
Professional Enrollment ID
I20240116003380
Address ID
ME049386138FA672XXRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

362 MENTAL HEALTH COUNSELOR in ME

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Provider Addresses for ELLEN MIRIAM GRUNBLATT (MD, LCPC)

  • 672, Wilton Road, Farmington, Franklin County, Maine, 04938, United States

    FARMINGTON, ME 049386138

    Phone: (207) 778-5792

    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: 2024-01-16

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
I20240116003380IMental Health CounselorMETBD

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 04938)

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Reviews

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Frequently asked questions

Where can patients find ELLEN MIRIAM GRUNBLATT (MD, LCPC)'s NPI?
You can confirm ELLEN MIRIAM GRUNBLATT (MD, LCPC) with NPI 1114019759; it appears in the national provider directory.
Is ELLEN MIRIAM GRUNBLATT (MD, LCPC)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does ELLEN MIRIAM GRUNBLATT (MD, LCPC) work in?
You can think of ELLEN MIRIAM GRUNBLATT (MD, LCPC) as practicing within Professional Counselor. Clinical services aligned with this taxonomy classification.
Does ELLEN MIRIAM GRUNBLATT (MD, LCPC) practice in Maine?
You will see Farmington, Maine on file for ELLEN MIRIAM GRUNBLATT (MD, LCPC) alongside any extra practice locations.
How can I contact ELLEN MIRIAM GRUNBLATT (MD, LCPC)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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