EXTASY GRINN (NPI# 1124534912) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124534912 |
| Entity Type | Individual |
| Full Name | EXTASY GRINN |
| Credential | LCSW, CAP. ICADC |
| Practice Address |
2030 Chilhowee Medical Park Maryville TN 37804-5285 |
| Mailing Address |
4799 Palmbrooke Cir West Palm Beach FL 33417-7534 |
| Practice Telephone | 8659823400 |
| Practice Fax Number | 8652382034 |
| Mailing Telephone | 5618768751 |
| Enumeration Date | 2017-12-16 |
| Last Update Date | 2020-10-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
ADC-003288-2014 | FL | Behavioral Health & Social Service Providers |
| Y | 104100000X | Social Worker | 7341 | TN | Behavioral Health & Social Service Providers |
| N | 1041C0700X |
Social Worker Specialization: Clinical |
SW14806 | FL | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4799 Palmbrooke Cir, West Palm Beach, FL 334177534 | 5618768751 |
| Street Address |
2030 CHILHOWEE MEDICAL PARK |
| City | MARYVILLE |
| State | TN |
| Zip Code | 37804-5285 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376502955 | Marilyn H Marshall | Speech-Language Pathologist | 2030 Chilhowee Medical Park, Maryville, TN 37804-5285 | 2006-03-21 |
| 1437758588 | Anne Mudge Rice | Speech-Language Pathologist | 2030 Chilhowee Medical Park, Maryville, TN 37804-5285 | 2020-10-20 |
| 1477165785 | Margaret Meares | Speech-Language Pathologist | 2030 Chilhowee Medical Park, Maryville, TN 37804-5285 | 2020-08-18 |
| 1205447646 | Cassaundra Sutton | Speech-Language Pathologist | 2030 Chilhowee Medical Park, Maryville, TN 37804-5285 | 2020-08-10 |
| 1962011072 | Emma Cordelia Newton | Occupational Therapist | 2030 Chilhowee Medical Park, Maryville, TN 37804-5285 | 2020-07-24 |
| 1912525841 | Sarah Eliazbeth King | Speech-Language Pathologist | 2030 Chilhowee Medical Park, Maryville, TN 37804-5285 | 2020-07-07 |
| 1063030989 | Briana Gaines | Speech-Language Pathologist | 2030 Chilhowee Medical Park, Maryville, TN 37804-5285 | 2020-07-07 |
| 1275172389 | Claudia Robinette | Speech-Language Pathologist | 2030 Chilhowee Medical Park, Maryville, TN 37804-5285 | 2020-01-06 |
| 1306497037 | Laura Williams Smith | Speech-Language Pathologist | 2030 Chilhowee Medical Park, Maryville, TN 37804-5285 | 2019-09-24 |
| 1790332872 | Melissa Jane Breeden | Speech-Language Pathologist | 2030 Chilhowee Medical Park, Maryville, TN 37804-5285 | 2019-08-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659835825 | Matthew David Mallory | Physical Therapist | Morning View Village 2320 E. Lamar Alexander Parway, Maryville, TN 37804 | 2019-01-22 |
| 1063937290 | Rachel Ryan Mcmillan | Counselor | 362 High Street, Maryville, TN 37804 | 2017-08-09 |
| 1316461460 | Steven Casey Boring | Nurse Practitioner | 907 E. Lamar Alexander Pkwy., Maryville, TN 37804 | 2017-07-31 |
| 1851738751 | Robert Kane Mccall | Pathology | 250 E. Broadway, Maryville, TN 37804 | 2013-05-31 |
| 1619242849 | Jennifer Mcclements | Physical Therapy Assistant | 4004 Samuel Circle, Maryville, TN 37804 | 2012-03-21 |
| 1316223886 | Sabrina Nicole Powers | Social Worker | 1704 East Broadway, Maryville, TN 37804 | 2011-10-28 |
| 1407138381 | Russmann, Inc. | Ambulance | 4163 Benny Delozier Drive, Maryville, TN 37804 | 2011-09-15 |
| 1184932485 | Complete Family Care of Maryville, Pllc | Internal Medicine | 2004 E. Broadway, Maryville, TN 37804 | 2010-09-21 |
| 1093975096 | Kristi Clark Correll | Speech-Language Pathologist | 2030 East Lamar Alexander Parkway, Maryville, TN 37804 | 2008-06-12 |
| 1134388267 | Barbara Frantz Poulsen | Speech-Language Pathologist | 2030 E Lamar Alexander Parkway, Maryville, TN 37804 | 2008-06-04 |
| Find all providers in zip 37804 | ||||
| Taxonomy Code | 104100000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Social Worker |
| A social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. |
| Notes: Source: National Association of Social Workers, 2009 [7/1/2009: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396370359 | Tabitha Ann Vanvranken | Social Worker | 512 Singletree Cir, Maryville, TN 37801-8651 | 2020-03-10 |
| 1417303157 | Edgar Tyrone Fritz | Social Worker | 2628 Morganton Rd, Maryville, TN 37801-8445 | 2016-05-12 |
| 1760822464 | Nicci C. Grigsby | Social Worker | 547 W. Lamar Alexander Pkwy, Maryville, TN 37801-4760 | 2013-06-27 |
| 1801002142 | Mackenzie R Pherigo | Social Worker | 2148 Vadalabene Dr, Maryville, IL 62062-5632 | 2007-05-15 |
| 1447258629 | Cynthia Ann Grimm | Social Worker | 659 Morganton Square Dr, Maryville, TN 37801-4763 | 2005-07-12 |
| 1124628672 | Ashley Hope Burbine | Social Worker | 309 N Houston St, Maryville, TN 37801-4733 | 2020-10-26 |
| 1790390086 | Jennifer Smith | Social Worker | 309 N Houston St, Maryville, TN 37801-4733 | 2020-09-13 |
| 1780297002 | Graham Scott Paschall | Social Worker | 1704 E Broadway Ave, Maryville, TN 37804-2916 | 2020-08-26 |
| 1427601749 | Kristen R Kessler | Social Worker | 1704 E Broadway Ave, Maryville, TN 37804-2916 | 2019-07-17 |
| 1679139612 | Elizabeth Bauman | Social Worker | 1704 E Broadway Ave, Maryville, TN 37804-2916 | 2019-05-15 |
| Find all providers in MARYVILLE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.