Provider Demographics
NPI:1295279875
Name:GRUMMEL, ESTHER MARIA (LICSW)
Entity type:Individual
Prefix:
First Name:ESTHER
Middle Name:MARIA
Last Name:GRUMMEL
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3207 VALLETTE ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1847
Mailing Address - Country:US
Mailing Address - Phone:360-201-5245
Mailing Address - Fax:
Practice Address - Street 1:103 E HOLLY ST STE 319
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4728
Practice Address - Country:US
Practice Address - Phone:360-389-2994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-15
Last Update Date:2020-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW603439971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical