Provider Demographics
NPI:1952133944
Name:GREBERMAN, MELISSA GAIL (LCSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:GAIL
Last Name:GREBERMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 SUNNY AYR WAY
Mailing Address - Street 2:
Mailing Address - City:LANSDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19446-5120
Mailing Address - Country:US
Mailing Address - Phone:267-380-0677
Mailing Address - Fax:
Practice Address - Street 1:1310 SUNNY AYR WAY
Practice Address - Street 2:
Practice Address - City:LANSDALE
Practice Address - State:PA
Practice Address - Zip Code:19446-5120
Practice Address - Country:US
Practice Address - Phone:267-380-0677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-17
Last Update Date:2024-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0228001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical