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General NPI Number Information
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NPI Number | 1275920555
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Entity Type | Organization
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Legal Business Name | GRUBBS COUNSELING & CONSULTING, LLC
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Dates
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Enumeration Date | 04/23/2015
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Last Update Date | 04/23/2015
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Provider Practice Location Address
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Address Line | 215 BRECKENRIDGE LN SUITE 203
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City | LOUISVILLE
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State | KY
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Zip | 40207-3800
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Country | US
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Telephone | 502-931-5624
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Fax |
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Provider Business Mailing Address
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Address Line | 111 WILDWOOD LN
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City | LOUISVILLE
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State | KY
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Zip | 40223-2851
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Country | US
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Telephone | 502-931-5624
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Fax |
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Authorized Official
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Title or Position | MEMBER / PRESIDENT
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Name | MR. ROBERT GRUBBS II
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Credential | LCSW
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Telephone | 502-931-5624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4038
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License Number State | KY
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