Healthcare Provider Details

I. General information

NPI: 1033033550
Provider Name (Legal Business Name): DIANE CATHERINE GROGAN LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 W 36TH ST FL 14
NEW YORK NY
10018-7152
US

IV. Provider business mailing address

379 HARMAN ST APT 5E
BROOKLYN NY
11237-4878
US

V. Phone/Fax

Practice location:
  • Phone: 929-399-7120
  • Fax:
Mailing address:
  • Phone: 516-993-6324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number002832
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: