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NPI Code Detail

MEDICARE: STEPHANIE GRILLO LPC

MEDICARE: STEPHANIE GRILLO LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorC.1902139OH

General Provider Information

NPI Number : 1063843993
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE GRILLO LPC
Provider Business Mailing Address
First Line : 11401 LORAIN AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-5428
Country : US
Telephone Number : 215-527-6315
Fax Number :
Provider Business Practice Location Address
First Line : 11401 LORAIN AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-5428
Country : US
Telephone Number : 216-416-4277
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2013
Last Update Date : 10/27/2019

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Directions to “ STEPHANIE GRILLO LPC” Practice Location

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