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General NPI Number Information
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NPI Number | 1104092733
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Entity Type | Individual
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Provider Name | WAYNE ALAN GROSNICK CAP
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Gender | Male
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Dates
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Enumeration Date | 05/04/2008
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Last Update Date | 05/04/2008
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Provider Practice Location Address
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Address Line | 13191 STARKEY RD SUITE 14
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City | LARGO
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State | FL
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Zip | 33773-1400
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Country | US
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Telephone | 727-586-6942
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Fax | 727-216-7692
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Provider Business Mailing Address
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Address Line | 13191 STARKEY RD SUITE 14
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City | LARGO
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State | FL
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Zip | 33773-1400
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Country | US
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Telephone | 727-586-6942
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Fax | 727-216-7692
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 25033
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | R831
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 2848
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License Number State | WA
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Taxonomy #4
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1201
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 12225
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 50357
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License Number State | FL
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