Individual
MR. JESSE GRONBACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW, LCSW, PMHNP
Contact information
Practice address
5 KITCHIN PL # 220, ASHEVILLE, NC 28803-2665
(828) 505-1762
(828) 505-1763
Mailing address
18 REGENT PARK BLVD STE A, ASHEVILLE, NC 28806-3727
(828) 505-1762
(828) 505-1763
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
C007267
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5017230
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3410049
—
NC
Enumeration date
04/30/2010
Last updated
03/01/2023
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