Provider Demographics
NPI:1912867912
Name:STEPHANIE RENEE GRINDELL MENTAL HEALTH COUNSELOR, P.C.
Entity type:Organization
Organization Name:STEPHANIE RENEE GRINDELL MENTAL HEALTH COUNSELOR, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:GRINDELL
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:631-484-4018
Mailing Address - Street 1:7 ROMAN CT
Mailing Address - Street 2:
Mailing Address - City:LAKE GROVE
Mailing Address - State:NY
Mailing Address - Zip Code:11755-2318
Mailing Address - Country:US
Mailing Address - Phone:631-484-4018
Mailing Address - Fax:
Practice Address - Street 1:7 ROMAN CT
Practice Address - Street 2:
Practice Address - City:LAKE GROVE
Practice Address - State:NY
Practice Address - Zip Code:11755-2318
Practice Address - Country:US
Practice Address - Phone:631-484-4018
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-13
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty