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General NPI Number Information
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NPI Number | 1043924525
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Entity Type | Organization
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Legal Business Name | GRAY MATTERS, GREENWICH
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Dates
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Enumeration Date | 01/10/2023
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Last Update Date | 01/10/2023
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Provider Practice Location Address
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Address Line | 1455 E PUTNAM AVE
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City | OLD GREENWICH
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State | CT
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Zip | 06870-1360
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Country | US
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Telephone | 203-956-3060
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Fax |
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Provider Business Mailing Address
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Address Line | 1455 E PUTNAM AVE
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City | OLD GREENWICH
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State | CT
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Zip | 06870-1360
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Country | US
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Telephone | 203-956-3060
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | MRS. ALISA NICOLE PILLAI
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Credential | LCSW
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Telephone | 914-325-3896
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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