Healthcare Provider Details

I. General information

NPI: 1659814812
Provider Name (Legal Business Name): KRISTI ANN GRAZIANO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/21/2016
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 S CONGRESS AVE
WEST PALM BEACH FL
33406-7608
US

IV. Provider business mailing address

2330 S CONGRESS AVE
WEST PALM BEACH FL
33406-7608
US

V. Phone/Fax

Practice location:
  • Phone: 561-432-5849
  • Fax: 561-432-9732
Mailing address:
  • Phone: 516-381-1624
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number097368
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number18420
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: