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NPI Code Detail

MEDICARE: MISS JENNIFER ROSE GRILLO LCSW

MEDICARE: MISS JENNIFER ROSE GRILLO LCSW
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 CounselorSW19747FL
21041C0700XClinical Social WorkerSW19747FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295485449
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JENNIFER ROSE GRILLO LCSW
Provider Business Mailing Address
First Line : 13350 W COLONIAL DR STE 340
Second Line :
City : WINTER GARDEN
State : FL
Zip : 34787-3977
Country : US
Telephone Number : 352-697-1707
Fax Number :
Provider Business Practice Location Address
First Line : 13350 W COLONIAL DR STE 340
Second Line :
City : WINTER GARDEN
State : FL
Zip : 34787-3977
Country : US
Telephone Number : 352-697-1707
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2022
Last Update Date : 04/20/2026

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Directions to “ MISS JENNIFER ROSE GRILLO LCSW” Practice Location

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