MEDICARE: GRIEF TO RELIEF LLC.

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

General Provider Information

NPI Number	:	1861035792
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRIEF TO RELIEF LLC.

Provider Business Mailing Address
First Line	:	8616 JOURNAL CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-3338
Country	:	US
Telephone Number	:	702-556-9958
Fax Number	:

Provider Business Practice Location Address
First Line	:	8616 JOURNAL CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89117-3338
Country	:	US
Telephone Number	:	702-556-9958
Fax Number	:

Authorized Official
Title or Position	:	MARRIAGE AND FAMILY THERAPIST
Name	:	MR. JOSEPH PERRONI
Credential	:	LMFT
Telephone Number	:	702-556-9958

Provider Enumeration Date	:	10/23/2019
Last Update Date	:	10/23/2019

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Directions to “GRIEF TO RELIEF LLC. ” Practice Location

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