Healthcare Provider Details

I. General information

NPI: 1396759502
Provider Name (Legal Business Name): DEBORAH LYNN GRAN-PALUMBO MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

386 STANLEY ST
FALL RIVER MA
02720-6009
US

IV. Provider business mailing address

16 PARK ST
WARREN RI
02885-2410
US

V. Phone/Fax

Practice location:
  • Phone: 508-324-3535
  • Fax:
Mailing address:
  • Phone: 401-245-4394
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5377
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number00194
License Number StateRI

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: