Provider Demographics
NPI:1215468699
Name:GRIECO, DANIELLA (LCSW)
Entity type:Individual
Prefix:MRS
First Name:DANIELLA
Middle Name:
Last Name:GRIECO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MISS
Other - First Name:DANIELLA
Other - Middle Name:
Other - Last Name:SIMONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28 DEER RUN RD
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-3306
Mailing Address - Country:US
Mailing Address - Phone:860-986-3582
Mailing Address - Fax:
Practice Address - Street 1:28 DEER RUN RD
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-3306
Practice Address - Country:US
Practice Address - Phone:860-986-3582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-27
Last Update Date:2017-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT92501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical