Provider Demographics
NPI:1205266046
Name:GRIGSBY, DEBORAH LYNNE (LPC, NCC, MA-MHC)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:LYNNE
Last Name:GRIGSBY
Suffix:
Gender:F
Credentials:LPC, NCC, MA-MHC
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:LYNNE
Other - Last Name:BENARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2566
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:OR
Mailing Address - Zip Code:97439
Mailing Address - Country:US
Mailing Address - Phone:541-999-1913
Mailing Address - Fax:
Practice Address - Street 1:1490 1ST STREET, UNIT #1
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:OR
Practice Address - Zip Code:97439
Practice Address - Country:US
Practice Address - Phone:541-999-1913
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-14
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 106H00000X, 101YM0800X
ORC4249101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist