Provider Demographics
NPI:1144431164
Name:GRIGSBY, ANDREA E (LCSW)
Entity type:Individual
Prefix:MS
First Name:ANDREA
Middle Name:E
Last Name:GRIGSBY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 722
Mailing Address - Street 2:
Mailing Address - City:MOUNT WASHINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40047-0722
Mailing Address - Country:US
Mailing Address - Phone:502-552-4560
Mailing Address - Fax:502-637-4490
Practice Address - Street 1:4815 N. PRESTON HIGHWAY
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40047-8419
Practice Address - Country:US
Practice Address - Phone:502-552-4560
Practice Address - Fax:502-637-4490
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-46081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical