Provider Demographics
NPI:1437950870
Name:GRITSUNOV, LIUBOV (LGSW)
Entity type:Individual
Prefix:
First Name:LIUBOV
Middle Name:
Last Name:GRITSUNOV
Suffix:
Gender:F
Credentials:LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 FLORIDA AVE NE APT 1409
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-9048
Mailing Address - Country:US
Mailing Address - Phone:201-621-2196
Mailing Address - Fax:
Practice Address - Street 1:4000 ALBEMARLE ST NW STE 5005TH
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20016-1851
Practice Address - Country:US
Practice Address - Phone:202-531-5385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-21
Last Update Date:2025-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLG200002987104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker