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Individual

CANDICE ELIZABETH GRELLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LMHC

Contact information

Practice address
30 E 60TH ST RM 208, NEW YORK, NY 10022-7135
(212) 847-0144
(212) 847-0144
Mailing address
PO BOX 142, SCARSDALE, NY 10583-0142
(914) 441-8199

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
001887
NY
101YS0200X
School Counselor
NY
103K00000X
Behavior Analyst
NY
106S00000X
Behavior Technician
NY
174400000X
Specialist
NY
208D00000X
General Practice Physician
001887
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001887
NYS OFFICE OF THE PROFESSIONS LMHC
NY
Enumeration date
05/02/2019
Last updated
05/02/2019
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