Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jennifer Stuart Grissom

Individual provider Mental Health Counselor · NPI 1659055507

Jennifer Stuart Grissom is a Mental Health Counselor in Shallotte, North Carolina. Practices as a sole proprietor. Licensed in Virginia.

Licensed in
VA
In the registry since
2023

Practice location Address checks out

5320 Bridgers Rd Ste 4
Shallotte, NC 28470-4737
Phone: (910) 769-9126
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 0704013796 (VA)

Record details

NPI number1659055507
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJune 12, 2023
Last updated in NPPESJune 12, 2023
Certification dateJune 12, 2023
Mailing address6472 Rolling Run Rd, Southport, NC 28461-8302

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