Healthcare Provider Details

I. General information

NPI: 1598174047
Provider Name (Legal Business Name): MICHELLE GRANDIN LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2014
Last Update Date: 09/12/2026
Certification Date: 09/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

57 EAST MAIN ST STE 215
WESTBOROUGH MA
01581-1457
US

IV. Provider business mailing address

57 EAST MAIN STREET SUITE 215
WESTBOROUGH MA
01581-1457
US

V. Phone/Fax

Practice location:
  • Phone: 513-655-3178
  • Fax:
Mailing address:
  • Phone: 513-655-3178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number213924
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: