Healthcare Provider Details

I. General information

NPI: 1003271461
Provider Name (Legal Business Name): BRITTANY GRINSTEAD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: BRITTANY CARTER

II. Dates (important events)

Enumeration Date: 12/29/2015
Last Update Date: 07/08/2021
Certification Date: 07/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

733 KEYSER AVE STE 120
NATCHITOCHES LA
71457-0039
US

IV. Provider business mailing address

733 KEYSER AVE STE 120
NATCHITOCHES LA
71457-0039
US

V. Phone/Fax

Practice location:
  • Phone: 318-238-4030
  • Fax: 318-787-5768
Mailing address:
  • Phone: 318-238-4030
  • Fax: 318-787-5768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: