Provider Demographics
NPI:1932062379
Name:MIGLIORE, GRANT CHARLES (LMSW)
Entity type:Individual
Prefix:
First Name:GRANT
Middle Name:CHARLES
Last Name:MIGLIORE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 HILTON AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-2817
Mailing Address - Country:US
Mailing Address - Phone:516-798-4070
Mailing Address - Fax:516-778-5795
Practice Address - Street 1:65 HILTON AVE STE 201
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-2817
Practice Address - Country:US
Practice Address - Phone:516-798-4070
Practice Address - Fax:516-778-5795
Is Sole Proprietor?:No
Enumeration Date:2025-12-03
Last Update Date:2025-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY125858104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker