MS. MARISSA CAREY GRANT MA, LCMHCA, NCC
NPI 1174288146
Counselor - Mental Health in Charlotte, NC

Q: What is Marissa Grant's NPI number?

The NPI number for Marissa Grant is 1174288146. It was assigned to this individual provider in the NPPES registry on November 4, 2021.

Q: What is Marissa Grant's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: Is Marissa Grant enrolled in Medicare?

No. Marissa Grant has opted out of Medicare through October 10, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Marissa Grant was last updated on November 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 04, 2021Opted out of Medicare · through Oct 10, 2026

7401 CARMEL EXECUTIVE PARK DR STE 210, CHARLOTTE, NC 28226(704) 752-8414(704) 544-1109 Get Directions Write a Review

NPPES record last updated: November 4, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Ms. Marissa Carey Grant Ma, Lcmhca, Ncc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. MARISSA CAREY GRANT MA, LCMHCA, NCC (NPI 1174288146) is an individual mental health provider in Charlotte, North Carolina, licensed in North Carolina (A16932) and active in the NPI registry since November 2021. She has opted out of Medicare through October 10, 2026 and remains eligible to order and refer.

NPPES Registry Identity

NPI1174288146

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameMS. MARISSA CAREY GRANTCredential: MA, LCMHCA, NCC

Location Address7401 CARMEL EXECUTIVE PARK DR STE 210Charlotte, NC 28226-0406

Mailing Address7401 Carmel Executive Park Dr Ste 210Charlotte, NC 28226-0406 · (704) 752-8414 · Fax (704) 544-1109

Phone(704) 752-8414

Fax(704) 544-1109

Sole ProprietorNo

Enumeration DateNovember 4, 2021

NPPES CertifiedNovember 4, 2021

✔ NPI 1174288146 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in NC · A16932

7401 CARMEL EXECUTIVE PARK DR STE 210, Charlotte, NC 28226

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Ms. Marissa Carey Grant Ma, Lcmhca, Ncc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 10, 2024 through October 10, 2026.

Opt-Out Effective DateOctober 10, 2024

Opt-Out In Effect ThroughOctober 10, 2026Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 19

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROBLYNNE MCDUFFIE BOSTIC LCMHC

Counselor (Mental Health)