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Individual

MARY CATHERINE GRANT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NCC/CCMHC/LCMHC/LCAS

Contact information

Practice address
100 S MARSHALL ST STE 1, WINSTON SALEM, NC 27101-2843
(362) 761-2783
(336) 276-1516
Mailing address
100 S MARSHALL ST STE 1, WINSTON SALEM, NC 27101-2843
(336) 276-1278
(336) 276-1516

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-21990
NC
101YP2500X
Professional Counselor
Primary
11728
NC

Other

Enumeration date
08/30/2016
Last updated
06/16/2023
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