Provider Demographics
NPI:1043656663
Name:GRIGSBY-THEDFORD, CATRINA ROMONA (LSW, CADC)
Entity type:Individual
Prefix:MRS
First Name:CATRINA
Middle Name:ROMONA
Last Name:GRIGSBY-THEDFORD
Suffix:
Gender:F
Credentials:LSW, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 E FLAMINGO RD STE 218
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-5124
Mailing Address - Country:US
Mailing Address - Phone:702-265-1153
Mailing Address - Fax:
Practice Address - Street 1:2121 E FLAMINGO RD STE 218
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-5124
Practice Address - Country:US
Practice Address - Phone:702-265-1153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-22
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
NV01226101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst