Provider Demographics
NPI:1346837432
Name:GRIGGS, MARY KATHRYN (LICSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:KATHRYN
Last Name:GRIGGS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:KATHRYN
Other - Last Name:MCALISTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:120 CAMBRIDGE POINTE DR
Mailing Address - Street 2:
Mailing Address - City:ALABASTER
Mailing Address - State:AL
Mailing Address - Zip Code:35007-5161
Mailing Address - Country:US
Mailing Address - Phone:205-913-7570
Mailing Address - Fax:
Practice Address - Street 1:120 CAMBRIDGE POINTE DR
Practice Address - Street 2:
Practice Address - City:ALABASTER
Practice Address - State:AL
Practice Address - Zip Code:35007-5161
Practice Address - Country:US
Practice Address - Phone:205-913-7570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-23
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2402C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL2402COtherCLINICAL SOCIAL WORK LICENSE