Provider Demographics
NPI:1053440263
Name:GRINER, MAUREEN PATRICIA (LPC)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:PATRICIA
Last Name:GRINER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6120 STEAMBOAT CT
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80919-2104
Mailing Address - Country:US
Mailing Address - Phone:719-659-3531
Mailing Address - Fax:
Practice Address - Street 1:801 N WEBER ST APT 204
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903-5927
Practice Address - Country:US
Practice Address - Phone:719-659-3531
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4130101Y00000X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional