Active NPI
Ladra Pearl Grissom
- Mental Health Counselor
- Tacoma, WA
National Provider Identifier
1871357749
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- MC70025907
- Practice address
- 6201 Pacific Ave Ste C3
Tacoma, WA 98408-7423 - Phone
- (253) 363-8853
- NPI assigned
- Feb 12, 2024
- Last updated
- Jan 2, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | MC70025907 | WA | Primary |
Addresses
Primary practice location
6201 Pacific Ave Ste C3
Tacoma, WA 98408-7423
Mailing address
14207 103Rd Avenue CT E Apt B303
Puyallup, WA 98374-3839
Phone (206) 638-9836
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MC70025907 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Transitions L.L.C. | Mental Health | Current | Accepting new patients |
Locations
6201 Pacific Ave
Ste C3
Tacoma, WA 98408
Phone (253) 363-1453
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Life Transitions
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Tacoma, WA
- NPI 1609374040
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767312000000",
"number": "1871357749",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14207 103RD AVENUE CT E APT B303",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983743839",
"telephone_number": "206-638-9836"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6201 PACIFIC AVE STE C3",
"city": "TACOMA",
"state": "WA",
"postal_code": "984087423",
"telephone_number": "253-363-8853"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRISSOM",
"first_name": "LADRA",
"middle_name": "PEARL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-12",
"last_updated": "2026-01-02",
"certification_date": "2026-01-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "MC70025907",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.