Provider Demographics
NPI:1902180771
Name:GRENEVICH, NIYA S (MS)
Entity Type:Individual
Prefix:
First Name:NIYA
Middle Name:S
Last Name:GRENEVICH
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:NIYA
Other - Middle Name:SHANTE
Other - Last Name:ADAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:351 W SCHUYLKILL RD STE G15A
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19465-7438
Mailing Address - Country:US
Mailing Address - Phone:610-326-9460
Mailing Address - Fax:
Practice Address - Street 1:351 W SCHUYLKILL RD STE G-15A
Practice Address - Street 2:
Practice Address - City:POTTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:19465-7438
Practice Address - Country:US
Practice Address - Phone:610-326-9460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-28
Last Update Date:2023-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
PAPC015023101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst