Provider Demographics
NPI:1457454795
Name:GRIT, OLIVIA MICHELLE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:OLIVIA
Middle Name:MICHELLE
Last Name:GRIT
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 BEECH STREET
Mailing Address - Street 2:
Mailing Address - City:NEWLAND
Mailing Address - State:NC
Mailing Address - Zip Code:28657-0040
Mailing Address - Country:US
Mailing Address - Phone:828-733-5889
Mailing Address - Fax:828-262-5687
Practice Address - Street 1:895 STATE FARM RD
Practice Address - Street 2:SUITE 508
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-4917
Practice Address - Country:US
Practice Address - Phone:828-264-9007
Practice Address - Fax:828-262-5687
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1143106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCPENDINGMedicaid