Provider Demographics
NPI:1013669332
Name:GRIT CITY COUNSELING, LLC
Entity Type:Organization
Organization Name:GRIT CITY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:PICO
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:253-302-4639
Mailing Address - Street 1:3121 S 7TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-2506
Mailing Address - Country:US
Mailing Address - Phone:253-302-4639
Mailing Address - Fax:
Practice Address - Street 1:3121 S 7TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-2506
Practice Address - Country:US
Practice Address - Phone:253-302-4639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty