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General NPI Number Information
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NPI Number | 1255095337
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Entity Type | Individual
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Provider Name | MR. STEVEN B GRINDSTAFF
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Gender | Male
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Dates
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Enumeration Date | 10/26/2021
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Last Update Date | 10/26/2021
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Provider Practice Location Address
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Address Line | 2305 N GATEWAY AVE UNIT 4
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City | HARRIMAN
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State | TN
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Zip | 37748-8683
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Country | US
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Telephone | 452-213-4882
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Fax |
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Provider Business Mailing Address
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Address Line | 119 TERRACE ST
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City | ELIZABETHTON
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State | TN
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Zip | 37643-6588
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Country | US
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Telephone | 423-345-8285
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 7766
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License Number State | TN
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