Provider Demographics
NPI:1407185945
Name:GRISSO, PATRICIA ELIZABETH (LMFT, LPC)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ELIZABETH
Last Name:GRISSO
Suffix:
Gender:F
Credentials:LMFT, LPC
Other - Prefix:
Other - First Name:TRISH
Other - Middle Name:
Other - Last Name:GRISSO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMFT, LPC
Mailing Address - Street 1:9029 BENEVOLENT CT
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:76227-1303
Mailing Address - Country:US
Mailing Address - Phone:940-765-0880
Mailing Address - Fax:
Practice Address - Street 1:9029 BENEVOLENT CT
Practice Address - Street 2:
Practice Address - City:PROVIDENCE VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:76227-1303
Practice Address - Country:US
Practice Address - Phone:940-765-0880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-11
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14903101YP2500X, 101Y00000X
TX4917106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist