Provider Demographics
NPI:1548890692
Name:GRADY, JENARA DANIELLE (LPCC)
Entity type:Individual
Prefix:MRS
First Name:JENARA
Middle Name:DANIELLE
Last Name:GRADY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:MRS
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:GRADY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPCC
Mailing Address - Street 1:575 INDUSTRIAL PKWY
Mailing Address - Street 2:
Mailing Address - City:HEATH
Mailing Address - State:OH
Mailing Address - Zip Code:43056-1647
Mailing Address - Country:US
Mailing Address - Phone:740-618-8388
Mailing Address - Fax:740-522-4673
Practice Address - Street 1:575 INDUSTRIAL PKWY
Practice Address - Street 2:
Practice Address - City:HEATH
Practice Address - State:OH
Practice Address - Zip Code:43056-1647
Practice Address - Country:US
Practice Address - Phone:740-618-8388
Practice Address - Fax:740-522-4673
Is Sole Proprietor?:No
Enumeration Date:2020-01-16
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2303862101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional