MEDICARE: MRS. HEATHER ANN GRINAR MA, LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	PC005720	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PC005720	OTHER	PA	LPC

General Provider Information

NPI Number	:	1992009534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HEATHER ANN GRINAR MA, LPC

Provider Business Mailing Address
First Line	:	1120 W TOWNSHIP LINE RD STE 101
Second Line	:
City	:	HAVERTOWN
State	:	PA
Zip	:	19083-4930
Country	:	US
Telephone Number	:	610-708-0721
Fax Number	:	267-285-1994

Provider Business Practice Location Address
First Line	:	1120 W TOWNSHIP LINE RD STE 101
Second Line	:
City	:	HAVERTOWN
State	:	PA
Zip	:	19083-4930
Country	:	US
Telephone Number	:	610-708-0721
Fax Number	:	267-285-1994

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2010
Last Update Date	:	04/29/2024

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