Provider Demographics
NPI:1558369728
Name:GRIGG-GEORGE, LYNN RUSSELL (EDS, LPC)
Entity Type:Individual
Prefix:MISS
First Name:LYNN
Middle Name:RUSSELL
Last Name:GRIGG-GEORGE
Suffix:
Gender:M
Credentials:EDS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22802-4632
Mailing Address - Country:US
Mailing Address - Phone:540-433-3100
Mailing Address - Fax:540-432-6989
Practice Address - Street 1:463 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802-4853
Practice Address - Country:US
Practice Address - Phone:540-433-3100
Practice Address - Fax:540-432-6989
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002656101Y00000X, 101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA393238OtherANTHEM BCBS
VA082387OtherSENTARA/OPTIMA