Provider Demographics
NPI:1922534700
Name:GREY MATTER CONCEIRGE COUNSELING,INC.
Entity Type:Organization
Organization Name:GREY MATTER CONCEIRGE COUNSELING,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANICE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUTLET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-810-9886
Mailing Address - Street 1:2902 BANKS ST
Mailing Address - Street 2:APT A
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119-7310
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2902 BANKS ST
Practice Address - Street 2:APT A
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-7310
Practice Address - Country:US
Practice Address - Phone:504-810-9886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty