Provider Demographics
NPI:1346278181
Name:VIRGA, GRISSELLE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:GRISSELLE
Middle Name:
Last Name:VIRGA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 FRANKLIN AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530-5760
Mailing Address - Country:US
Mailing Address - Phone:516-280-9030
Mailing Address - Fax:516-280-9029
Practice Address - Street 1:601 FRANKLIN AVE STE 120
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5760
Practice Address - Country:US
Practice Address - Phone:516-280-9030
Practice Address - Fax:516-280-9029
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2021-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker