Provider Demographics
NPI:1548345333
Name:GRANDE, HARRIET MARI (LCSW-R, LCAT)
Entity type:Individual
Prefix:MS
First Name:HARRIET
Middle Name:MARI
Last Name:GRANDE
Suffix:
Gender:F
Credentials:LCSW-R, LCAT
Other - Prefix:MS
Other - First Name:MARI
Other - Middle Name:
Other - Last Name:GRANDE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW, LCAT, ATR-BC
Mailing Address - Street 1:555 KAPPOCK ST APT 26A
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-6434
Mailing Address - Country:US
Mailing Address - Phone:917-535-7576
Mailing Address - Fax:615-858-7576
Practice Address - Street 1:295 MADISON AVE FL 12
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-6379
Practice Address - Country:US
Practice Address - Phone:212-871-6856
Practice Address - Fax:615-858-7576
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72 071122104100000X
NY720711221041S0200X
NY05000197221700000X
NY73 0767401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist