Provider Demographics
NPI:1851680672
Name:DEVINE-GREHAN, CATHERINE CLAIRE (PHD)
Entity Type:Individual
Prefix:DR
First Name:CATHERINE
Middle Name:CLAIRE
Last Name:DEVINE-GREHAN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:KATIE
Other - Middle Name:CLAIRE
Other - Last Name:DEVINE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:1417 SURREY LANE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570
Mailing Address - Country:US
Mailing Address - Phone:516-536-1026
Mailing Address - Fax:
Practice Address - Street 1:365 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:LYNBROOK
Practice Address - State:NY
Practice Address - Zip Code:11563-3027
Practice Address - Country:US
Practice Address - Phone:516-238-8733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-01
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012130103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool