Provider Demographics
NPI:1770528929
Name:GRIER, MELVIN T (LCSW, CAC III)
Entity type:Individual
Prefix:MR
First Name:MELVIN
Middle Name:T
Last Name:GRIER
Suffix:
Gender:M
Credentials:LCSW, CAC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11310 ALLENDALE DR
Mailing Address - Street 2:
Mailing Address - City:PEYTON
Mailing Address - State:CO
Mailing Address - Zip Code:80831-6842
Mailing Address - Country:US
Mailing Address - Phone:719-661-4426
Mailing Address - Fax:719-960-2574
Practice Address - Street 1:1304 N ACADEMY BLVD STE 101
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-3318
Practice Address - Country:US
Practice Address - Phone:719-661-4426
Practice Address - Fax:719-960-2574
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2020-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACC.0002176101YA0400X
COCSW009896081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty