Provider Demographics
NPI:1588861298
Name:GRUN, ALTON FRANCIS (PHD, LPC)
Entity type:Individual
Prefix:MR
First Name:ALTON
Middle Name:FRANCIS
Last Name:GRUN
Suffix:
Gender:M
Credentials:PHD, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98-1038 MOANALUA RD
Mailing Address - Street 2:APT 1008
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4620
Mailing Address - Country:US
Mailing Address - Phone:714-472-7086
Mailing Address - Fax:
Practice Address - Street 1:98-1038 MOANALUA RD
Practice Address - Street 2:APT 1008
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4620
Practice Address - Country:US
Practice Address - Phone:714-472-7086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-27
Last Update Date:2015-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14042101YP2500X
FL2688101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional