Provider Demographics
NPI:1417670597
Name:GRENIER, ISABELLE EVE (LMHC)
Entity Type:Individual
Prefix:
First Name:ISABELLE
Middle Name:EVE
Last Name:GRENIER
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 1:2000 MASSACHUSETTS AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02140-2100
Mailing Address - Country:US
Mailing Address - Phone:857-288-8392
Mailing Address - Fax:
Practice Address - Street 1:2000 MASSACHUSETTS AVE STE 4
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-2100
Practice Address - Country:US
Practice Address - Phone:857-288-8392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-22
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC12979101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health