Provider Demographics
NPI:1093580094
Name:GRUBE, BRITTANY (LMHC)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:GRUBE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 MARYLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON BAYS
Mailing Address - State:NY
Mailing Address - Zip Code:11946-2611
Mailing Address - Country:US
Mailing Address - Phone:631-603-9504
Mailing Address - Fax:
Practice Address - Street 1:3 NEPTUNE AVE
Practice Address - Street 2:
Practice Address - City:HAMPTON BAYS
Practice Address - State:NY
Practice Address - Zip Code:11946-2405
Practice Address - Country:US
Practice Address - Phone:631-603-9504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY008895101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health