Michelle Grennan, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

021973 Issued in NY

Practice address

765 Gramatan Ave
Mount Vernon, NY 10552-1043

Phone

(914) 310-7943

NPI assigned

Jan 9, 2017

Sex

Female

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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Epic Long IslandGroup PAC ID 7315835907, 43 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Epic Long Island

  • Voluntary or Charitable Agency
  • East Meadow, NY
  • NPI 1174563936
  Medicare reassignment Care Compare group NPD
• Epilepsy Foundation of L.I.

  • Voluntary or Charitable Agency
  • Garden City, NY
  • NPI 1467755785
  NPD
• Lewis a. Opler, M.D., PH.D., P.C.

  • Psychiatry Physician
  • Mount Vernon, NY
  • NPI 1578750253
  NPD (past)

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568678400000",
    "number": "1922544477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 GRAMATAN AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105521043",
            "telephone_number": "914-310-7943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 GRAMATAN AVE",
            "city": "MOUNT VERNON",
            "state": "NY",
            "postal_code": "105521043",
            "telephone_number": "914-310-7943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRENNAN",
        "first_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-09",
        "last_updated": "2019-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "021973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sophia Edukere Green
• Wallycinth Green
• Greenlight Health
• Greenspark Health
• Paola Greiger-Zanlungo, M.D.
• Christene Marie Grey, LMT
• Charlene M Grinion, FNP
• Beth Gross, SOCIAL WORK INTERN
• Lindsay Grossman, MA, MSW
• Growing Pearls Pediatric Dentistry PLLC

• Clinical Psychologist in Mount Vernon, NY
• Providers in Mount Vernon, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.