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General NPI Number Information
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NPI Number | 1609977404
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Entity Type | Individual
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Provider Name | MARY ANN ALEXANDRA GRONCKI MSW LCSW
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Gender | Female
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 3 PAOLI PLAZA MARY ANN A GRONCKI MSW LCSW SUITE D
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City | PAOLI
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State | PA
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Zip | 19301
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Country | US
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Telephone | 215-292-3276
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Fax |
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Provider Business Mailing Address
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Address Line | 713 04 STATE ROAD MARY ANN GRONCKI
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City | BERWYN
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State | PA
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Zip | 19312
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Country | US
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Telephone | 215-292-3276
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Fax |
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | CW014618
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW014618
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License Number State | PA
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