Provider Demographics
NPI:1932320868
Name:GRILLO, ANGELA ROSE ANN (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:ROSE ANN
Last Name:GRILLO
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6608 NETTIES LN UNIT 1406
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22315-6063
Mailing Address - Country:US
Mailing Address - Phone:315-345-8472
Mailing Address - Fax:
Practice Address - Street 1:6608 NETTIES LN UNIT 1406
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22315-6063
Practice Address - Country:US
Practice Address - Phone:315-345-8472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2021-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040126881041C0700X
NYR0395521041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical