Provider Demographics
NPI:1619736477
Name:GRIESE, CLAIRE ELLEN (LPC, NCC, BC-TMH)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:ELLEN
Last Name:GRIESE
Suffix:
Gender:F
Credentials:LPC, NCC, BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5519 HAMILTON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-7515
Mailing Address - Country:US
Mailing Address - Phone:703-595-3308
Mailing Address - Fax:
Practice Address - Street 1:100 STARR AVE STE K
Practice Address - Street 2:
Practice Address - City:STARKVILLE
Practice Address - State:MS
Practice Address - Zip Code:39759-4032
Practice Address - Country:US
Practice Address - Phone:662-340-5947
Practice Address - Fax:662-200-5960
Is Sole Proprietor?:No
Enumeration Date:2024-03-14
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3091101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional