Provider Demographics
NPI:1619858198
Name:GRINDROD, KAYLEE (LCPC)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:
Last Name:GRINDROD
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 AVA RD
Mailing Address - Street 2:
Mailing Address - City:SEVERN
Mailing Address - State:MD
Mailing Address - Zip Code:21144-3306
Mailing Address - Country:US
Mailing Address - Phone:484-818-0667
Mailing Address - Fax:
Practice Address - Street 1:1310 AVA RD
Practice Address - Street 2:
Practice Address - City:SEVERN
Practice Address - State:MD
Practice Address - Zip Code:21144-3306
Practice Address - Country:US
Practice Address - Phone:484-818-0667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC16940101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty