Provider Demographics
NPI:1780390757
Name:GRZENIEWSKI, RENATA (LMHC)
Entity type:Individual
Prefix:
First Name:RENATA
Middle Name:
Last Name:GRZENIEWSKI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 MAIN ST APT 815
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10044-0046
Mailing Address - Country:US
Mailing Address - Phone:718-640-7061
Mailing Address - Fax:
Practice Address - Street 1:159 BLEECKER ST APT 2A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-1490
Practice Address - Country:US
Practice Address - Phone:646-548-7542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013121101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health