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General NPI Number Information
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NPI Number | 1619736477
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Entity Type | Individual
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Provider Name | CLAIRE ELLEN GRIESE LPC, NCC, BC-TMH
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Gender | Female
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Dates
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Enumeration Date | 03/14/2024
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Last Update Date | 04/17/2024
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Provider Practice Location Address
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Address Line | 100 STARR AVE STE K
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City | STARKVILLE
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State | MS
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Zip | 39759-4032
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Country | US
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Telephone | 662-340-5947
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Fax | 662-200-5960
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Provider Business Mailing Address
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Address Line | 5519 HAMILTON AVE
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City | COLUMBUS
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State | MS
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Zip | 39705-7515
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Country | US
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Telephone | 703-595-3308
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3091
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License Number State | MS
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