Provider Demographics
NPI:1982029898
Name:GRADY, EMILY (MA, LPCC)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:
Last Name:GRADY
Suffix:
Gender:F
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:C/O FRANKLIN CIRCLE CHRISTIAN CHURCH
Mailing Address - Street 2:1688 FULTON ROAD
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44113
Mailing Address - Country:US
Mailing Address - Phone:440-941-6004
Mailing Address - Fax:
Practice Address - Street 1:C/O FRANKLIN CIRCLE CHRISTIAN CHURCH
Practice Address - Street 2:1688 FULTON ROAD
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44113
Practice Address - Country:US
Practice Address - Phone:440-941-6004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-28
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1800508101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health