Healthcare Provider Details

I. General information

NPI: 1467796565
Provider Name (Legal Business Name): FRANK GRASSO JR. MS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/15/2012
Last Update Date: 02/26/2024
Certification Date: 06/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1009 MAITLAND CENTER COMMONS BLVD STE 212
MAITLAND FL
32751-7270
US

IV. Provider business mailing address

2275 SILAS DEANE HWY
ROCKY HILL CT
06067-2329
US

V. Phone/Fax

Practice location:
  • Phone: 800-840-2528
  • Fax:
Mailing address:
  • Phone: 203-671-9538
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: