Provider Demographics
NPI:1093852246
Name:GRANEY, TERESA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:
Last Name:GRANEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:72700 DINAH SHORE DRIVE
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92211-0818
Mailing Address - Country:US
Mailing Address - Phone:909-825-7084
Mailing Address - Fax:909-422-3002
Practice Address - Street 1:72700 DINAH SHORE DRIVE
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92211-0818
Practice Address - Country:US
Practice Address - Phone:909-825-7084
Practice Address - Fax:909-422-3002
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL83001041C0700X
CA839261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical