Individual
MR. GRANT STEVEN JAMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M. A. LCPC
Contact information
Practice address
650 HUEBNER RD, FORT RILEY, KS 66442-4030
(785) 239-7667
(630) 570-5779
Mailing address
650 HUEBNER RD, FORT RILEY, KS 66442-4030
(785) 239-7667
(630) 570-5779
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCA082
MD
101YP2500X
Professional Counselor
Primary
LC1219
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
007788700
—
MD
01
—
204199756
FED TAX ID
MD
01
—
780208000
MAGELLAN
MD
01
—
W7220001
BCBS CAREFIRST
MD
Enumeration date
01/09/2007
Last updated
08/02/2022
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