Provider Demographics
NPI:1902338536
Name:GRASSO, MICHELLE FERRONE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:FERRONE
Last Name:GRASSO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 S LAKELINE BLVD
Mailing Address - Street 2:APT 3302
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-3593
Mailing Address - Country:US
Mailing Address - Phone:574-386-1973
Mailing Address - Fax:
Practice Address - Street 1:2201 S LAKELINE BLVD
Practice Address - Street 2:APT 3302
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-3593
Practice Address - Country:US
Practice Address - Phone:574-386-1973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-02
Last Update Date:2017-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX584481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical