Provider Demographics
NPI:1427219062
Name:GRENIER, DENISE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:GRENIER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S CONVENT AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85701-2647
Mailing Address - Country:US
Mailing Address - Phone:510-670-4865
Mailing Address - Fax:520-670-4785
Practice Address - Street 1:300 W CONGRESS ST STE 8N
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85701-1383
Practice Address - Country:US
Practice Address - Phone:520-670-4865
Practice Address - Fax:520-670-4785
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-111071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZLCSW-11107OtherARIZONA BOARD OF BEHAVIORAL HEALTH LICENSE NUMBER