Provider Demographics
NPI:1275920555
Name:GRUBBS COUNSELING & CONSULTING, LLC
Entity Type:Organization
Organization Name:GRUBBS COUNSELING & CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER / PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUBBS
Authorized Official - Suffix:II
Authorized Official - Credentials:LCSW
Authorized Official - Phone:502-931-5624
Mailing Address - Street 1:111 WILDWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2851
Mailing Address - Country:US
Mailing Address - Phone:502-931-5624
Mailing Address - Fax:
Practice Address - Street 1:215 BRECKENRIDGE LN
Practice Address - Street 2:SUITE 203
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-3800
Practice Address - Country:US
Practice Address - Phone:502-931-5624
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY40381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty