Provider Demographics
NPI:1760822464
Name:GRIGSBY, NICCI C (LMSW)
Entity Type:Individual
Prefix:
First Name:NICCI
Middle Name:C
Last Name:GRIGSBY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:NICCI
Other - Middle Name:C
Other - Last Name:WILLIAMSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:201 W SPRINGDALE AVE
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-5158
Mailing Address - Country:US
Mailing Address - Phone:658-637-9711
Mailing Address - Fax:865-637-4362
Practice Address - Street 1:100 ADAMS LN
Practice Address - Street 2:
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-4909
Practice Address - Country:US
Practice Address - Phone:865-483-7743
Practice Address - Fax:865-482-1855
Is Sole Proprietor?:No
Enumeration Date:2013-06-27
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN12374104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker