MEDICARE: DREW LANI GRISSELL

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	101YM0800X	Mental Health Counselor	IMH24000	FL

General Provider Information

NPI Number	:	1427730373
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DREW LANI GRISSELL

Provider Business Mailing Address
First Line	:	357 PINEVIEW DR
Second Line	:
City	:	VENICE
State	:	FL
Zip	:	34293-3940
Country	:	US
Telephone Number	:	541-515-5267
Fax Number	:

Provider Business Practice Location Address
First Line	:	3231 GULF GATE DR STE 201
Second Line	:
City	:	SARASOTA
State	:	FL
Zip	:	34231-2406
Country	:	US
Telephone Number	:	941-367-2356
Fax Number	:

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

Provider Enumeration Date	:	08/01/2023
Last Update Date	:	02/20/2026

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Directions to “ DREW LANI GRISSELL ” Practice Location

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