Provider Demographics
NPI:1346034386
Name:ESTRADA, GRISEL (LMSW)
Entity type:Individual
Prefix:
First Name:GRISEL
Middle Name:
Last Name:ESTRADA
Suffix:
Gender:
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2043 BENEDICT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-4403
Mailing Address - Country:US
Mailing Address - Phone:917-383-7959
Mailing Address - Fax:
Practice Address - Street 1:1824 MADISON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-3832
Practice Address - Country:US
Practice Address - Phone:212-423-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY125917104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker