Patrick Bryan Granelli, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC05512300 Issued in NJ

Practice address

112 Prospect St
Ridgewood, NJ 07450-4489

Phone

(201) 674-3673

Fax

(201) 444-0698

NPI assigned

Dec 8, 2012

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1354924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354924800000",
    "number": "1306181938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 WESTERVELT AVE",
            "city": "HAWTHORNE",
            "state": "NJ",
            "postal_code": "075063817",
            "telephone_number": "201-674-3673",
            "fax_number": "201-444-0698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 PROSPECT ST",
            "city": "RIDGEWOOD",
            "state": "NJ",
            "postal_code": "074504489",
            "telephone_number": "201-674-3673",
            "fax_number": "201-444-0698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANELLI",
        "first_name": "PATRICK",
        "middle_name": "BRYAN",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-12-08",
        "last_updated": "2012-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05512300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne Goodwin
• Francine Gordon, LCSW
• Hamilton C Goulart, M.D.
• Alisa Stephanie Goulbourne-Scott, PA-C
• Janine N. Goulet, APN
• Grant N Ko MD
• Juan B Grau, M.D.
• Julie M Grayson
• Great Moments
• Greatest Moments Counseling, Inc

• Clinical Social Worker in Ridgewood, NJ
• Providers in Ridgewood, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.