Provider Demographics
NPI:1497810816
Name:GRANATO GROUP, INC.
Entity Type:Organization
Organization Name:GRANATO GROUP, INC.
Other - Org Name:GRANATO COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRANATO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:703-831-8300
Mailing Address - Street 1:1360 BEVERLY RD.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MCLEAN
Mailing Address - State:VA
Mailing Address - Zip Code:22101
Mailing Address - Country:US
Mailing Address - Phone:703-831-8300
Mailing Address - Fax:703-636-1300
Practice Address - Street 1:1360 BEVERLY RD. SUITE 200
Practice Address - Street 2:
Practice Address - City:MCLEAN
Practice Address - State:VA
Practice Address - Zip Code:22101
Practice Address - Country:US
Practice Address - Phone:703-831-8300
Practice Address - Fax:703-636-1300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-26
Last Update Date:2020-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701002672101YP2500X
103TB0200X, 103TC0700X, 103TC1900X, 103TC2200X
VA0717000710106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & BehavioralGroup - Multi-Specialty
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAS297OtherBLUE CROSS BLUE SHIELD
VA103501OtherANTHEM
VAG01917Medicare ID - Type Unspecified