Provider Demographics
NPI:1578636296
Name:HALL GROSETT, MARIE-ELENA CATHERINE (PHD, LCSW-R)
Entity Type:Individual
Prefix:DR
First Name:MARIE-ELENA
Middle Name:CATHERINE
Last Name:HALL GROSETT
Suffix:
Gender:F
Credentials:PHD, LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:218 SANDPIPER CT
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-1968
Mailing Address - Country:US
Mailing Address - Phone:914-329-0920
Mailing Address - Fax:
Practice Address - Street 1:2127 CROMPOND RD
Practice Address - Street 2:SUITE 104A
Practice Address - City:CORTLANDT MANOR
Practice Address - State:NY
Practice Address - Zip Code:10567-4329
Practice Address - Country:US
Practice Address - Phone:914-737-7487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2013-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR034771-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400054848Medicare PIN
NYN467C1Medicare ID - Type Unspecified