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

Mrs. Jenny Marie Grissom

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1730424219

Mrs. Jenny Marie Grissom is a Clinical Social Worker in Ukiah, California. Qualified in 2015, 11 years ago. Licensed in California.

Years since qualifying
11
Licensed in
CA
In the registry since
2012
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Practice location Address checks out

1120 S Dora St
Ukiah, CA 95482-6340
Phone: (707) 472-2637
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Addiction (Substance Use Disorder) Counselor (primary) Taxonomy 101YA0400X · Licence RI-G1004211925 (CA)

Record details

NPI number1730424219
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedDecember 10, 2012
Last updated in NPPESDecember 10, 2012

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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