Provider Demographics
NPI:1922025477
Name:GRINTSVAYG, SVETLANA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SVETLANA
Middle Name:
Last Name:GRINTSVAYG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1723 E 12TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1069
Mailing Address - Country:US
Mailing Address - Phone:917-703-0749
Mailing Address - Fax:718-615-7452
Practice Address - Street 1:1723 E 12TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1069
Practice Address - Country:US
Practice Address - Phone:917-703-0749
Practice Address - Fax:718-615-7452
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02202399Medicaid
NYNY3991Medicare PIN