Provider Demographics
NPI:1861446171
Name:GRINTER, JAMES WILLIAM III (MSW/LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:WILLIAM
Last Name:GRINTER
Suffix:III
Gender:M
Credentials:MSW/LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 REGENCY PARK N.
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804
Mailing Address - Country:US
Mailing Address - Phone:518-812-0806
Mailing Address - Fax:
Practice Address - Street 1:84 BROAD ST
Practice Address - Street 2:VA PRIMARY CARE
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12801-4381
Practice Address - Country:US
Practice Address - Phone:518-761-2692
Practice Address - Fax:518-761-2097
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR063899-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical