Healthcare Provider Details

I. General information

NPI: 1437150968
Provider Name (Legal Business Name): JOHN FRANCIS GRZEBIENIAK PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

128 LEEPER DR
NEW CASTLE PA
16102-2716
US

IV. Provider business mailing address

128 LEEPER DR
NEW CASTLE PA
16102-2716
US

V. Phone/Fax

Practice location:
  • Phone: 724-667-9528
  • Fax:
Mailing address:
  • Phone: 724-667-9528
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number84049
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number3293
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number3448
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: