Healthcare Provider Details

I. General information

NPI: 1124896972
Provider Name (Legal Business Name): GRIN GRANT INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2023
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

628 N BROADWAY STE 302
LEXINGTON KY
40508-3726
US

IV. Provider business mailing address

7145 E VIRGINIA ST STE 2000
EVANSVILLE IN
47715-9147
US

V. Phone/Fax

Practice location:
  • Phone: 859-309-0150
  • Fax: 859-309-0154
Mailing address:
  • Phone: 812-962-7894
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. MARY HELEN SHASHY
Title or Position: EXECUTIVE DIRECTOR
Credential: APSS
Phone: 859-629-1214