Provider Demographics
NPI:1316664170
Name:NEVINS, GRACE CATHERINE (LMSW)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:CATHERINE
Last Name:NEVINS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 1ST AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-9424
Mailing Address - Country:US
Mailing Address - Phone:805-252-8440
Mailing Address - Fax:
Practice Address - Street 1:39 1ST AVE APT 1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-9424
Practice Address - Country:US
Practice Address - Phone:805-252-8440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-24
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1169411041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical