Provider Demographics
NPI:1740783729
Name:CATALINA GRANJA, LCSW, INC
Entity Type:Organization
Organization Name:CATALINA GRANJA, LCSW, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CATALINA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:GRANJA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:954-464-4971
Mailing Address - Street 1:1179 NW 97TH DR
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-5962
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 NW 70TH AVE RM 306
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33313-6028
Practice Address - Country:US
Practice Address - Phone:954-464-4971
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW48381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty