Provider Demographics
NPI:1821183682
Name:STITT, GROVER C III (LCSW-R)
Entity Type:Individual
Prefix:MR
First Name:GROVER
Middle Name:C
Last Name:STITT
Suffix:III
Gender:M
Credentials:LCSW-R
Other - Prefix:MR
Other - First Name:STEVE
Other - Middle Name:
Other - Last Name:STITT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:80 N MOORE ST
Mailing Address - Street 2:APARTMENT 37J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-2701
Mailing Address - Country:US
Mailing Address - Phone:212-233-8408
Mailing Address - Fax:
Practice Address - Street 1:98 RIVERSIDE DR
Practice Address - Street 2:SUITE 1A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-5323
Practice Address - Country:US
Practice Address - Phone:917-208-8692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2011-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR018700-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical