Provider Demographics
NPI:1902964687
Name:GRIGRY, KAREN SUE (MED LPC)
Entity Type:Individual
Prefix:MS
First Name:KAREN
Middle Name:SUE
Last Name:GRIGRY
Suffix:
Gender:F
Credentials:MED LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 W BABCOCK STR
Mailing Address - Street 2:SUITE #C
Mailing Address - City:BOZEMAN
Mailing Address - State:MT
Mailing Address - Zip Code:59715-4018
Mailing Address - Country:US
Mailing Address - Phone:406-586-0093
Mailing Address - Fax:406-587-1821
Practice Address - Street 1:1609 W BABCOCK STR
Practice Address - Street 2:SUITE C
Practice Address - City:BOZEMAN
Practice Address - State:MT
Practice Address - Zip Code:59715-4018
Practice Address - Country:US
Practice Address - Phone:406-586-0093
Practice Address - Fax:406-587-1821
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLPC#276101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT74750OtherBCBS
MT0254864Medicaid