Provider Demographics
NPI:1083812234
Name:D'ONOFRIO, GRACE (MS NCC LPC)
Entity Type:Individual
Prefix:MS
First Name:GRACE
Middle Name:
Last Name:D'ONOFRIO
Suffix:
Gender:F
Credentials:MS NCC LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-2116
Mailing Address - Country:US
Mailing Address - Phone:203-512-4157
Mailing Address - Fax:
Practice Address - Street 1:81 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-2116
Practice Address - Country:US
Practice Address - Phone:203-512-4157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTCT0001594101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional