Provider Demographics
NPI:1588024491
Name:GRINDER, JOEL
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:GRINDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2048 OVERLAND AVE STE 102B
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-7428
Mailing Address - Country:US
Mailing Address - Phone:406-647-0817
Mailing Address - Fax:
Practice Address - Street 1:2048 OVERLAND AVE STE 102B
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-7428
Practice Address - Country:US
Practice Address - Phone:406-647-0817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-04
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTBBH-LCPC-LIC-16487101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional