Provider Demographics
NPI:1184768582
Name:GRADY, CLIFF - - - (LMFT & LADC)
Entity type:Individual
Prefix:MR
First Name:CLIFF
Middle Name:- - -
Last Name:GRADY
Suffix:
Gender:M
Credentials:LMFT & LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2696 STEWART AVE
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423-9289
Mailing Address - Country:US
Mailing Address - Phone:775-315-4259
Mailing Address - Fax:
Practice Address - Street 1:2696 STEWART AVE
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-9289
Practice Address - Country:US
Practice Address - Phone:775-315-4259
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV286101YA0400X
NV0294101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health