Provider Demographics
NPI:1831875186
Name:GRANT, SHAELEN (LMHC)
Entity type:Individual
Prefix:
First Name:SHAELEN
Middle Name:
Last Name:GRANT
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1159 SAINT JOHNS PL APT 3B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-2631
Mailing Address - Country:US
Mailing Address - Phone:206-794-2576
Mailing Address - Fax:
Practice Address - Street 1:201A E 124TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-2039
Practice Address - Country:US
Practice Address - Phone:929-899-5441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016037101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health