Healthcare Provider Details

I. General information

NPI: 1366970006
Provider Name (Legal Business Name): OSCAR DAVID GRAJALES JR. LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/25/2017
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date: 03/25/2026
Reactivation Date: 05/11/2026

III. Provider practice location address

2640 FOREST HILL BLVD
WEST PALM BEACH FL
33406-5931
US

IV. Provider business mailing address

10142 BOYNTON PLACE CIR
BOYNTON BEACH FL
33437-2657
US

V. Phone/Fax

Practice location:
  • Phone: 561-616-8411
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberSW25851
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: