EXTASY GRINN LCSW, CAP. ICADC
NPI 1124534912
Social Worker - Clinical in Maryville, TN

Q: What is Extasy Grinn's NPI number?

The NPI number for Extasy Grinn is 1124534912. It was assigned to this individual provider in the NPPES registry on December 16, 2017.

Q: What is Extasy Grinn's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Q: When was this NPI record last updated?

The NPPES record for Extasy Grinn was last updated on July 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 16, 2017PECOS EnrolledAccepts Medicare Assignment

2030 CHILHOWEE MEDICAL PARK, MARYVILLE, TN 37804(865) 982-3400(865) 238-2034 Get Directions Write a Review

NPPES record last updated: July 9, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 9, 2025, Oct 8, 2020, Dec 16, 2017 (3 updates tracked since 2017).

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About Extasy Grinn Lcsw, Cap. Icadc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EXTASY GRINN LCSW, CAP. ICADC (NPI 1124534912) is an individual clinical provider in Maryville, Tennessee, licensed in Tennessee (7341) and active in the NPI registry since December 2017. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Florida Atlantic University, College Of Medicine (2015).

NPPES Registry Identity

NPI1124534912

Entity TypeIndividualFemale

Primary Taxonomy1041C0700X

Provider Legal NameEXTASY GRINNCredential: LCSW, CAP. ICADC

Location Address2030 CHILHOWEE MEDICAL PARKMaryville, TN 37804-5285

Mailing Address4799 Palmbrooke CirWest Palm Beach, FL 33417-7534 · (561) 876-8751

Phone(865) 982-3400

Fax(865) 238-2034

Sole ProprietorYes

Medical School CMSFlorida Atlantic University, College Of MedicineGraduated 2015

Enumeration DateDecember 16, 2017

Last NPPES UpdateJuly 9, 20253 updates tracked since enumeration

NPPES CertifiedJuly 9, 2025

✔ NPI 1124534912 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

Licenses✔ Licensed in TN · 7341✔ Licensed in FL · SW14806

Definition

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 interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

Also ListedCounselor · Addiction (Substance Use Disorder)Taxonomy 101YA0400X · License ADC-003288-2014 (FL)

Also ListedSocial WorkerTaxonomy 104100000X · License 7341 (TN)

2030 CHILHOWEE MEDICAL PARK, Maryville, TN 37804

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Secondary Practice Locations 2

Location 14799 Palmbrooke CirWest Palm Beach, FL 33417-7534 · Phone (561) 876-8751

Location 210133 Sherrill Blvd Ste 220Knoxville, TN 37932-3775 · Phone (615) 320-1155 · Fax (615) 320-1177

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BlueCross BlueShield of Tennessee, Cigna Healthcare, Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Extasy Grinn Lcsw, Cap. Icadc is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1951662527

PECOS Enrollment IDI20221209000468

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Extasy Grinn reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Athena Consulting And Psychological Services, PLLC

163 mi

Clinical

220 ATHENS WAY STE 104
Nashville, TN 37228

Reassigned Medicare billing, Tennessee enrollment
80 clinicians in this Medicare group

NPI 1336292465 (615) 320-1155

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37804 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$0.00 typical visit price

range $52.64 – $160.89

Typical copayment $0.00 (range $13.16 – $40.22)

Most-billed visit code NA

Established Patient

$66.01 typical visit price

range $16.72 – $131.41

Typical copayment $16.50 (range $4.18 – $32.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HOLLY L THIELE CCC-SLP

Speech-Language Pathologist