Provider Demographics
NPI:1457800674
Name:GRINEV, LANA (LCSW)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:
Last Name:GRINEV
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:LANA
Other - Middle Name:
Other - Last Name:GRINEV
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2743 MILL AVE
Mailing Address - Street 2:SECOND FLOOR
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-6421
Mailing Address - Country:US
Mailing Address - Phone:917-703-7886
Mailing Address - Fax:
Practice Address - Street 1:777 SEAVIEW AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3409
Practice Address - Country:US
Practice Address - Phone:718-668-8061
Practice Address - Fax:718-668-8070
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY082020-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical