Individual provider · Type 1 NPI

Charles R. Granholm Jr., LCSW

Clinical Social Worker · Fort Knox, KY

NPI number 1619953213 Active

Practice location

200 Brule St Bldg Ireland
Fort Knox, KY 40121-6100

Call (502) 626-9885 Map

Mailing address

200 Brule St Bldg 871
Fort Knox, KY 40121-6100

Specialties and licenses

TaxonomyCodeLicense
Clinical Social Worker Primary 1041C0700X1308 (KY)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1619953213

Charles R. Granholm Jr., LCSW's National Provider Identifier is 1619953213, issued on Dec 16, 2005. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Fort Knox, KY. The record was last updated on Dec 4, 2023.