Provider Demographics
NPI:1134451347
Name:GRANT, PATRICIA LOUISE (LMHC)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:LOUISE
Last Name:GRANT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:TRISH
Other - Middle Name:
Other - Last Name:GRANT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1240 W SIMS WAY
Mailing Address - Street 2:141
Mailing Address - City:PORT TOWNSEND
Mailing Address - State:WA
Mailing Address - Zip Code:98368-3058
Mailing Address - Country:US
Mailing Address - Phone:360-379-5470
Mailing Address - Fax:
Practice Address - Street 1:141 OAK BAY RD
Practice Address - Street 2:
Practice Address - City:PORT HADLOCK
Practice Address - State:WA
Practice Address - Zip Code:98339-8718
Practice Address - Country:US
Practice Address - Phone:360-379-5470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-12
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60391478101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health