MEDICARE: STERLING THOMAS GRISSOM MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C019022	NC

General Provider Information

NPI Number	:	1881314102
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STERLING THOMAS GRISSOM MSW

Provider Business Mailing Address
First Line	:	447 ARLINGTON ST UNIT 2
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27406-1405
Country	:	US
Telephone Number	:	336-571-9490
Fax Number	:	336-916-5674

Provider Business Practice Location Address
First Line	:	447 ARLINGTON ST UNIT 2
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27406-1405
Country	:	US
Telephone Number	:	336-571-9490
Fax Number	:	336-916-5674

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2022
Last Update Date	:	05/03/2026

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