Provider Demographics
NPI:1821530676
Name:GRIGSBY, HOLLY P (MA, LMHC)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:P
Last Name:GRIGSBY
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3213 HARBOR AVE SW STE 1
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98126-4600
Mailing Address - Country:US
Mailing Address - Phone:206-552-0504
Mailing Address - Fax:
Practice Address - Street 1:3213 HARBOR AVE SW STE 1
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98126-4600
Practice Address - Country:US
Practice Address - Phone:206-552-0504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-10
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60835736101YM0800X
WAMC60292974101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA260471OtherFIRST CHOICE HEALTH NETWORK
WA6613862OtherAETNA