JENNIFER STUART GRISSOM NPI 1659055507

NPI Information

  • NPI: 1659055507
  • Provider Name: JENNIFER STUART GRISSOM
  • Classification: Counselor - 101YM0800X
  • Specialization: Mental Health
  • Entity Type: Individual
  • Address: 5320 BRIDGERS RD STE 4
    SHALLOTTE, NC
    ZIP 28470
  • Phone: (910) 769-9126

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NPI Details

Jennifer Stuart Grissom is a mental health counselor in Shallotte, NC. Jennifer Stuart Grissom NPI is 1659055507. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

5320 BRIDGERS RD STE 4
SHALLOTTE, NC
ZIP 28470-737
Phone: (910) 769-9126

The enumeration date for this NPI number is 6/12/2023 and was last updated on 6/12/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YM0800XCounselorMental Health0704013796VIRGINIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

NPI Synchronization or Removal

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