Healthcare Provider Details

I. General information

NPI: 1235257478
Provider Name (Legal Business Name): LAURA ELLEN GRASHOW PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAURA ELLEN GRASHOW-RYWELL PSY.D.

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4043 FAIRWAYS DR
CARMEL NY
10512-3935
US

IV. Provider business mailing address

4043 FAIRWAYS DR
CARMEL NY
10512-3935
US

V. Phone/Fax

Practice location:
  • Phone: 786-556-1566
  • Fax: 305-936-1022
Mailing address:
  • Phone: 786-556-1566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number004173
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPY6691
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License Number013417
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: