Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Angie Gruban

Individual provider Mental Health Counselor · NPI 1053031195

Angie Gruban is a Mental Health Counselor in Astoria, New York. Qualified in 2022, 4 years ago. Practices as a sole proprietor.

Years since qualifying
4
In the registry since
2022
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Practice location Address checks out

3075 47th St
Astoria, NY 11103-1530
Phone: (347) 686-4063
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1053031195
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedAugust 30, 2022
Last updated in NPPESAugust 30, 2022
Certification dateAugust 30, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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