# GRAND MESA THERAPY WASHINGTON PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1881526556
- **Authorized official:** HOLLY SHOCKLEY (OWNER)
- **Authorized official phone:** (970) 787-5100

## Contact information

- **Practice address:** 610 S 12TH ST, BISMARCK, ND 58504-5910
- **Practice address phone:** (970) 787-5100
- **Practice address fax:** (970) 787-5100
- **Mailing address:** 610 S 12TH ST, BISMARCK, ND 58504-5910

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YM0800X | Mental Health Counselor | — | NULL | Yes |
| 101YM0800X | Mental Health Counselor | — | — | Yes |

## Other

- **Enumeration date:** 05/29/2026
- **Last updated:** 07/09/2026