Provider Demographics
NPI:1477165058
Name:GRIZZLE, NICOLE MICHELLE (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:MICHELLE
Last Name:GRIZZLE
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4380 W 23RD STREET DR
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80634-3847
Mailing Address - Country:US
Mailing Address - Phone:970-313-7075
Mailing Address - Fax:
Practice Address - Street 1:375 E HORSETOOTH RD BLDG 2101
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525-3196
Practice Address - Country:US
Practice Address - Phone:970-484-1735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health