Provider Demographics
NPI:1336949569
Name:GRELLA, MEGAN ANN (LCSW)
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANN
Last Name:GRELLA
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:MEGAN
Other - Middle Name:ANN
Other - Last Name:MCALEER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:17 LATTINGTOWN RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:LOCUST VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:11560-1301
Mailing Address - Country:US
Mailing Address - Phone:516-662-9666
Mailing Address - Fax:
Practice Address - Street 1:7559 263RD ST
Practice Address - Street 2:
Practice Address - City:GLEN OAKS
Practice Address - State:NY
Practice Address - Zip Code:11004-1150
Practice Address - Country:US
Practice Address - Phone:516-662-9666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-17
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0840781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical