Provider Demographics
NPI:1548520190
Name:GRANDELSKI, NANCY LYNN (LCSW)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:LYNN
Last Name:GRANDELSKI
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 1:70 COTTAGE ST
Mailing Address - Street 2:
Mailing Address - City:DANIELSON
Mailing Address - State:CT
Mailing Address - Zip Code:06239-3014
Mailing Address - Country:US
Mailing Address - Phone:860-774-0215
Mailing Address - Fax:
Practice Address - Street 1:877 UPPER MAPLE ST
Practice Address - Street 2:
Practice Address - City:DAYVILLE
Practice Address - State:CT
Practice Address - Zip Code:06241-2228
Practice Address - Country:US
Practice Address - Phone:860-792-1266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-16
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0055121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical