Provider Demographics
NPI:1881864429
Name:GRADY, PATRICIA L (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:L
Last Name:GRADY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 CRAZY FARM LN
Mailing Address - Street 2:
Mailing Address - City:HINTON
Mailing Address - State:WV
Mailing Address - Zip Code:25951-5742
Mailing Address - Country:US
Mailing Address - Phone:727-433-4038
Mailing Address - Fax:304-466-0398
Practice Address - Street 1:411 TEMPLE ST
Practice Address - Street 2:
Practice Address - City:HINTON
Practice Address - State:WV
Practice Address - Zip Code:25951-2226
Practice Address - Country:US
Practice Address - Phone:304-466-2226
Practice Address - Fax:304-466-0398
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW29041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical