Provider Demographics
NPI:1861735581
Name:GRIGNON, TERESA F (MS, PMHCNS, BC)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:F
Last Name:GRIGNON
Suffix:
Gender:F
Credentials:MS, PMHCNS, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 EVERETT AVE
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150-1812
Mailing Address - Country:US
Mailing Address - Phone:617-889-8515
Mailing Address - Fax:617-889-8509
Practice Address - Street 1:151 EVERETT AVE
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-1812
Practice Address - Country:US
Practice Address - Phone:617-889-8515
Practice Address - Fax:617-889-8509
Is Sole Proprietor?:No
Enumeration Date:2013-04-01
Last Update Date:2016-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA106619163WP0809X, 364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health