Provider Demographics
NPI:1912599689
Name:GRANOFF, ELYSSA (LICSW)
Entity type:Individual
Prefix:
First Name:ELYSSA
Middle Name:
Last Name:GRANOFF
Suffix:
Gender:
Credentials:LICSW
Other - Prefix:
Other - First Name:ELYSSA
Other - Middle Name:
Other - Last Name:DEWOLFE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LICSW
Mailing Address - Street 1:47 OAKHURST RD
Mailing Address - Street 2:
Mailing Address - City:HOPKINTON
Mailing Address - State:MA
Mailing Address - Zip Code:01748-2721
Mailing Address - Country:US
Mailing Address - Phone:339-235-0921
Mailing Address - Fax:
Practice Address - Street 1:47 OAKHURST RD
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748-2721
Practice Address - Country:US
Practice Address - Phone:339-235-0921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-04
Last Update Date:2025-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2264951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical