Grant, Katie L

Grant, Katie L is an sole proprietor health care provider with primary practice located at 1800 3Rd Ave Ste 612 , Rock Island IL 61201-8039. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is her primary health care specialty. Grant, Katie L can be contacted via phone (309) 607-1000.

Contact Information

Primary practice address
1800 3Rd Ave Ste 612 Rock Island IL 61201-8039
Phone: (309) 607-1000
Fax: (815) 377-2599
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X
Behavioral Health & Social Service Providers / Professional 101YP2500X 180.007951 Illinois

Profile Details

NPI number 1538288212
LBN Legal business name Grant, Katie L
Credentials MS, LCPC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 27th, 2007
Last updated Dec 16th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538288212 NPPES
Iowa MEDICAID 1538288212

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