Provider Demographics
NPI:1073873683
Name:GRISEZ, JANEANE MARIE (LPCC, LICDC-CS)
Entity Type:Individual
Prefix:MRS
First Name:JANEANE
Middle Name:MARIE
Last Name:GRISEZ
Suffix:
Gender:F
Credentials:LPCC, LICDC-CS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8500 STATION ST STE 285
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-4972
Mailing Address - Country:US
Mailing Address - Phone:440-251-9325
Mailing Address - Fax:400-549-0935
Practice Address - Street 1:8500 STATION ST STE 285
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-4972
Practice Address - Country:US
Practice Address - Phone:440-251-9325
Practice Address - Fax:440-549-0935
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-17
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHICDC-081246-DU101YA0400X
OHGAMB.081246101YA0400X
OHE.1901052101YP2500X
OHC.1500080101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)