MR. SHANE OWEN GRANT
NPI 1043666779
Counselor - Mental Health in Manchester, CT
Active since May 12, 2016
About Mr. Shane Owen Grant NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. SHANE OWEN GRANT (NPI 1043666779) is an individual mental health provider in Manchester, Connecticut and active in the NPI registry since May 2016.
NPPES Registry Identity
NPI1043666779
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameMR. SHANE OWEN GRANT
Location Address91 ELM ST APT 312EManchester, CT 06040-8632
Mailing Address91 Elm St Apt 312eManchester, CT 06040-8632 · (860) 969-7147
Phone(860) 969-7147
Sole ProprietorNo
Enumeration DateMay 12, 2016
✔ NPI 1043666779 is a valid, active identifier and passes the ISO check-digit test.
Specialties & Licenses
★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
91 ELM ST APT 312E, Manchester, CT 06040
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1043666779, enumerated as an "individual" on May 12, 2016.
The provider is located at 91 ELM ST APT 312E MANCHESTER, CT 06040 and the phone number is (860) 969-7147.
Counselor with taxonomy code 101YM0800X and a focus in Mental Health.
