Healthcare Provider Details

I. General information

NPI: 1750874269
Provider Name (Legal Business Name): COURTNEY DEANN GRIGGS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2018
Last Update Date: 07/27/2020
Certification Date: 07/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 N UNIVERSITY AVE STE 200
LITTLE ROCK AR
72207-6360
US

IV. Provider business mailing address

1100 N UNIVERSITY AVE STE 201
LITTLE ROCK AR
72207-6359
US

V. Phone/Fax

Practice location:
  • Phone: 501-686-9300
  • Fax:
Mailing address:
  • Phone: 501-416-1902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: