Healthcare Provider Details

I. General information

NPI: 1073256442
Provider Name (Legal Business Name): DANIELLE SAMANTHA GRONDA MS, MHC-LP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

EAST NEW YORK CHILD AND FAMILY MENTAL HEALTH CENTER 2857 LINDEN BOULEVARD
BROOKLYN NY
11208
US

IV. Provider business mailing address

2857 LINDEN BLVD
BROOKLYN NY
11208-5126
US

V. Phone/Fax

Practice location:
  • Phone: 718-235-3100
  • Fax:
Mailing address:
  • Phone: 718-235-3100
  • 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: