Extasy Grinn, LCSW, CAP. ICADC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

7341 Issued in TN

Practice address

2030 Chilhowee Medical Park
Maryville, TN 37804-5285

Phone

(865) 982-3400

Fax

(865) 238-2034

NPI assigned

Dec 16, 2017

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Florida Atlantic University, College of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athena Consulting and Psychological Services, PLLCGroup PAC ID 5294719795, 60 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Athena Consulting and Psychological Services, PLLC

  • Clinical Psychologist
  • Nashville, TN
  • NPI 1336292465
  Medicare reassignment Care Compare group NPD
• Little Tennessee Valley Educational Cooperative

  • Local Education Agency (LEA)
  • Loudon, TN
  • NPI 1114256039
  NPD (past)
• Speech Pathology Services of East Tennessee LLC

  • Rehabilitation Clinic/Center
  • Maryville, TN
  • NPI 1659466712

  Clinical

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1513382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752019200000",
    "number": "1124534912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4799 PALMBROOKE CIR",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334177534",
            "telephone_number": "561-876-8751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 CHILHOWEE MEDICAL PARK",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045285",
            "telephone_number": "865-982-3400",
            "fax_number": "865-238-2034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4799 Palmbrooke Cir",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334177534",
            "country_code": "US",
            "telephone_number": "561-876-8751",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10133 Sherrill Blvd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379323775",
            "country_code": "US",
            "telephone_number": "615-320-1155",
            "fax_number": "615-320-1177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRINN",
        "first_name": "EXTASY",
        "credential": "LCSW, CAP. ICADC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-12-16",
        "last_updated": "2025-07-09",
        "certification_date": "2025-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "FL",
            "license": "ADC-003288-2014",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "TN",
            "license": "7341",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW14806",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "TN",
            "license": "7341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tristan Peyton Griffin, MSSW
• Todd Robert Griffith, M.D.
• Janice Yeary Grigsby, N.P.
• Traci C Grime, NP
• Cynthia Ann Grimm, LCSW
• Cassandra Grossman
• Ally Grubb, COTA/L
• Faye G Grubb, MSN
• Veronica Manaois Gubatan, MD
• David Ryan Guffey, MSW

• Clinical Social Worker in Maryville, TN
• Providers in Maryville, TN by specialty
• Clinical Social Worker in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.