Provider Demographics
NPI:1578607834
Name:GRANTNER, NATALIE MARTHA (MSW)
Entity Type:Individual
Prefix:MRS
First Name:NATALIE
Middle Name:MARTHA
Last Name:GRANTNER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:NATALIE
Other - Middle Name:MARTHA
Other - Last Name:SHAPIRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:4809 EAST 117TH AVENUE
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-8610
Mailing Address - Country:US
Mailing Address - Phone:219-805-9555
Mailing Address - Fax:
Practice Address - Street 1:9111 BROADWAY STE D
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-7092
Practice Address - Country:US
Practice Address - Phone:219-281-2335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
IN34007382A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor