Provider Demographics
NPI:1700571510
Name:MANNIX-SLOBIG, GRACE (LMSW)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:MANNIX-SLOBIG
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 8TH AVENUE, 9TH FLOOR
Mailing Address - Street 2:6S
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10018
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:519 8TH AVENUE, 9TH FLOOR
Practice Address - Street 2:6S
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10018
Practice Address - Country:US
Practice Address - Phone:917-688-4410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-07
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY113682104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker