Provider Demographics
NPI:1841164050
Name:GRISDELA, JULIET (LMHC)
Entity type:Individual
Prefix:
First Name:JULIET
Middle Name:
Last Name:GRISDELA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 ELM ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-2947
Mailing Address - Country:US
Mailing Address - Phone:617-702-9131
Mailing Address - Fax:
Practice Address - Street 1:255 ELM ST STE 201
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-2947
Practice Address - Country:US
Practice Address - Phone:617-702-9131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-01
Last Update Date:2025-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALMHC10004788101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health