Provider Demographics
NPI:1811559909
Name:GRAYSTONE GROUP LLC
Entity Type:Organization
Organization Name:GRAYSTONE GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:PINKSTON
Authorized Official - Suffix:II
Authorized Official - Credentials:LCSW
Authorized Official - Phone:228-669-6278
Mailing Address - Street 1:2218 18TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39501-2911
Mailing Address - Country:US
Mailing Address - Phone:228-669-6278
Mailing Address - Fax:
Practice Address - Street 1:2218 18TH ST STE B
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-2911
Practice Address - Country:US
Practice Address - Phone:401-300-4729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-28
Last Update Date:2019-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty