Provider Demographics
NPI:1922313519
Name:GRANT, ARACELI (MSED, LMHC, LCAC)
Entity Type:Individual
Prefix:
First Name:ARACELI
Middle Name:
Last Name:GRANT
Suffix:
Gender:F
Credentials:MSED, LMHC, LCAC
Other - Prefix:
Other - First Name:ARACELI
Other - Middle Name:
Other - Last Name:BUSTOS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:65 EMS C29 LN
Mailing Address - Street 2:
Mailing Address - City:WARSAW
Mailing Address - State:IN
Mailing Address - Zip Code:46582-9098
Mailing Address - Country:US
Mailing Address - Phone:317-693-9817
Mailing Address - Fax:574-267-2251
Practice Address - Street 1:65 EMS C29 LN
Practice Address - Street 2:
Practice Address - City:WARSAW
Practice Address - State:IN
Practice Address - Zip Code:46582-9098
Practice Address - Country:US
Practice Address - Phone:317-693-9817
Practice Address - Fax:574-267-2251
Is Sole Proprietor?:No
Enumeration Date:2010-08-09
Last Update Date:2019-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN39002444A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health