Provider Demographics
NPI:1972485688
Name:GRUNDY, THOMAS JAMES JR (LCSW)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:JAMES
Last Name:GRUNDY
Suffix:JR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 WALKER ST
Mailing Address - Street 2:
Mailing Address - City:ORLAND
Mailing Address - State:CA
Mailing Address - Zip Code:95963-1349
Mailing Address - Country:US
Mailing Address - Phone:530-961-3038
Mailing Address - Fax:
Practice Address - Street 1:418 WALKER ST
Practice Address - Street 2:
Practice Address - City:ORLAND
Practice Address - State:CA
Practice Address - Zip Code:95963-1349
Practice Address - Country:US
Practice Address - Phone:530-961-3038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-23
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1322881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical