Provider Demographics
NPI:1427536168
Name:GRINNELL, MORGAN ASHWILL (PHD)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:ASHWILL
Last Name:GRINNELL
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:BRITTANY
Other - Last Name:ASHWILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1004 DRESSER CT STE 103
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-7325
Mailing Address - Country:US
Mailing Address - Phone:919-876-5658
Mailing Address - Fax:
Practice Address - Street 1:1004 DRESSER CT STE 103
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-7325
Practice Address - Country:US
Practice Address - Phone:919-876-5658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-03
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5689103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist