Provider Demographics
NPI:1750874269
Name:GRIGGS, COURTNEY DEANN (MSW)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:DEANN
Last Name:GRIGGS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 N UNIVERSITY AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-6359
Mailing Address - Country:US
Mailing Address - Phone:501-416-1902
Mailing Address - Fax:
Practice Address - Street 1:1100 N UNIVERSITY AVE STE 200
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-6360
Practice Address - Country:US
Practice Address - Phone:501-686-9300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-08
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
104100000X
AR104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR928782110OtherDRIVERS LICENSE