Provider Demographics
NPI:1669747333
Name:GRINSHPUN, ANNA (LCPC, NCC)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:GRINSHPUN
Suffix:
Gender:F
Credentials:LCPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1416 LAKE ST STE 9
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4088
Mailing Address - Country:US
Mailing Address - Phone:224-260-6196
Mailing Address - Fax:847-556-0247
Practice Address - Street 1:1416 LAKE ST STE 9
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60201-4088
Practice Address - Country:US
Practice Address - Phone:224-260-6196
Practice Address - Fax:847-556-0247
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-14
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180008250101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional