Provider Demographics
NPI:1124812425
Name:GRIGOLETTI, MEGAN
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:GRIGOLETTI
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:856 LEO CT
Mailing Address - Street 2:
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341-2463
Mailing Address - Country:US
Mailing Address - Phone:908-458-7520
Mailing Address - Fax:
Practice Address - Street 1:856 LEO CT
Practice Address - Street 2:
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2463
Practice Address - Country:US
Practice Address - Phone:908-458-7520
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAPC001154101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor