MEDICARE: LYNETTE GRELET

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
1	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1366306938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNETTE GRELET

Provider Business Mailing Address
First Line	:	2380 PROFESSIONAL DR
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95403-3016
Country	:	US
Telephone Number	:	707-360-4379
Fax Number	:

Provider Business Practice Location Address
First Line	:	4211 HWY 116 S
Second Line	:
City	:	SEBASTOPOL
State	:	CA
Zip	:	95472-6030
Country	:	US
Telephone Number	:	707-235-8869
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2025
Last Update Date	:	12/09/2025

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Directions to “ LYNETTE GRELET ” Practice Location

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