Individual
MS. LISSA ANN GROSSMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
77 SUNRISE HILL RD, NORWALK, CT 06851-2113
(917) 658-9589
Mailing address
77 SUNRISE HILL RD, NORWALK, CT 06851-2113
(917) 658-9589
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
17214
NY
101YM0800X
Mental Health Counselor
Primary
075300-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
22553412
—
NY
Enumeration date
01/04/2021
Last updated
01/04/2021
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