Healthcare Provider Details

I. General information

NPI: 1649106964
Provider Name (Legal Business Name): GRAINGER COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 W JACKSON ST STE B
BOLIVAR MO
65613-1902
US

IV. Provider business mailing address

811 N MAIN AVE
BOLIVAR MO
65613-1037
US

V. Phone/Fax

Practice location:
  • Phone: 417-413-3464
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: RACHEL GRAINGER
Title or Position: OWNER
Credential: LCSW
Phone: 417-422-1242