Provider Demographics
NPI:1265807879
Name:GRUENBERG, DEANNE GINNS (LPC)
Entity type:Individual
Prefix:MRS
First Name:DEANNE
Middle Name:GINNS
Last Name:GRUENBERG
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 W 14 MILE RD
Mailing Address - Street 2:
Mailing Address - City:CLAWSON
Mailing Address - State:MI
Mailing Address - Zip Code:48017-1404
Mailing Address - Country:US
Mailing Address - Phone:248-872-8506
Mailing Address - Fax:248-549-0442
Practice Address - Street 1:808 W 14 MILE RD
Practice Address - Street 2:
Practice Address - City:CLAWSON
Practice Address - State:MI
Practice Address - Zip Code:48017
Practice Address - Country:US
Practice Address - Phone:248-872-8506
Practice Address - Fax:248-549-0442
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-08
Last Update Date:2018-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401002723101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional