Provider Demographics
NPI:1255541009
Name:STUART GREIF PSY D
Entity type:Organization
Organization Name:STUART GREIF PSY D
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:
Authorized Official - Last Name:GREIF
Authorized Official - Suffix:
Authorized Official - Credentials:PSY D
Authorized Official - Phone:863-293-3909
Mailing Address - Street 1:6700 S FLORIDA AVE
Mailing Address - Street 2:STE 13
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-3327
Mailing Address - Country:US
Mailing Address - Phone:863-293-3909
Mailing Address - Fax:863-293-1909
Practice Address - Street 1:6700 S FLORIDA AVE
Practice Address - Street 2:STE 13
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-3327
Practice Address - Country:US
Practice Address - Phone:863-293-3909
Practice Address - Fax:863-293-1909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY3817103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty