Provider Demographics
NPI:1821523705
Name:GRANSTAFF, RICHARD LYNN II (LPCC, CATC-IV)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:LYNN
Last Name:GRANSTAFF
Suffix:II
Gender:M
Credentials:LPCC, CATC-IV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1286 UNIVERSITY AVE # 202
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-3312
Mailing Address - Country:US
Mailing Address - Phone:619-995-6876
Mailing Address - Fax:
Practice Address - Street 1:1250 6TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92101-4368
Practice Address - Country:US
Practice Address - Phone:619-515-2430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-27
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA122582IV101YA0400X, 101YA0400X
CA12735101YP2500X, 101YP2500X
CAA06730315101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)