Healthcare Provider Details

I. General information

NPI: 1912734328
Provider Name (Legal Business Name): MARIA GRISH LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2024
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1489 W PALMETTO PARK RD STE 410
BOCA RATON FL
33486-3325
US

IV. Provider business mailing address

1499 W PALMETTO PARK RD STE 212
BOCA RATON FL
33486-3322
US

V. Phone/Fax

Practice location:
  • Phone: 561-600-4902
  • Fax:
Mailing address:
  • Phone: 561-600-4902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberMH23630
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMH23630
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMH23630
License Number StateFL
# 4
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH23630
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: