MEDICARE: GRIMALDI PSYCHOLOGICAL SERVICES, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	103TB0200X	Cognitive & Behavioral Psychologist
2	103TC0700X	Clinical Psychologist
3	103T00000X	Psychologist

General Provider Information

NPI Number	:	1891646170
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GRIMALDI PSYCHOLOGICAL SERVICES, PLLC

Provider Business Mailing Address
First Line	:	1410 NORTHERN BLVD # 1115
Second Line	:
City	:	MANHASSET
State	:	NY
Zip	:	11030-3051
Country	:	US
Telephone Number	:	646-543-1204
Fax Number	:

Provider Business Practice Location Address
First Line	:	2025 PALMETTO ST APT 1L
Second Line	:
City	:	RIDGEWOOD
State	:	NY
Zip	:	11385-3171
Country	:	US
Telephone Number	:	646-543-1204
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PSYCHOLOGIST
Name	:	DR. STEPHANIE JOSEPHINE GRIMALDI
Credential	:	PHD
Telephone Number	:	646-543-1204

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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