Provider Demographics
NPI:1811159742
Name:LEWIS-GRINWIS, NATASHA E (LMSW, CST)
Entity type:Individual
Prefix:MS
First Name:NATASHA
Middle Name:E
Last Name:LEWIS-GRINWIS
Suffix:
Gender:F
Credentials:LMSW, CST
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:455 E. EISENHOWER PKWY
Mailing Address - Street 2:SUITE 30
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48108-3304
Mailing Address - Country:US
Mailing Address - Phone:734-678-5029
Mailing Address - Fax:734-272-0574
Practice Address - Street 1:455 E. EISENHOWER PKWY
Practice Address - Street 2:SUITE 30
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-3304
Practice Address - Country:US
Practice Address - Phone:734-678-5029
Practice Address - Fax:734-272-0574
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801086965104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker