Provider Demographics
NPI:1710772322
Name:GRANDISON, MAURA (LMHCA)
Entity type:Individual
Prefix:MRS
First Name:MAURA
Middle Name:
Last Name:GRANDISON
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C/O ART BEZALEEL STUDIO GALLERY 12824 E. NORA AVE,
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216
Mailing Address - Country:US
Mailing Address - Phone:509-425-7895
Mailing Address - Fax:
Practice Address - Street 1:201 W NORTH RIVER DR STE 301
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2262
Practice Address - Country:US
Practice Address - Phone:509-903-0103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC61674811101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health