Provider Demographics
NPI:1992009534
Name:GRINAR, HEATHER ANN (MA, LPC)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ANN
Last Name:GRINAR
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 W TOWNSHIP LINE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-4930
Mailing Address - Country:US
Mailing Address - Phone:610-708-0721
Mailing Address - Fax:267-285-1994
Practice Address - Street 1:1120 W TOWNSHIP LINE RD STE 101
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-4930
Practice Address - Country:US
Practice Address - Phone:610-708-0721
Practice Address - Fax:267-285-1994
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-22
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005720101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC005720OtherLPC