Provider Demographics
NPI:1891817037
Name:GRANT, KRISTIN JOANNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:JOANNE
Last Name:GRANT
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 1:10233 S PARKER RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-9314
Mailing Address - Country:US
Mailing Address - Phone:720-438-5359
Mailing Address - Fax:720-836-4224
Practice Address - Street 1:10233 S PARKER RD
Practice Address - Street 2:SUITE 300
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-9314
Practice Address - Country:US
Practice Address - Phone:720-438-5359
Practice Address - Fax:720-836-4224
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-06
Last Update Date:2016-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO#7851041C0700X
CALCS209731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical