Healthcare Provider Details

I. General information

NPI: 1285541052
Provider Name (Legal Business Name): GRATTON THERAPY LMHC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 STAFFORD ST
WORCESTER MA
01603-1457
US

IV. Provider business mailing address

120 STAFFORD ST
WORCESTER MA
01603-1457
US

V. Phone/Fax

Practice location:
  • Phone: 774-262-3754
  • Fax:
Mailing address:
  • Phone: 774-262-3754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. KELLY ANN GRATTON
Title or Position: CLINICIAN
Credential: LMHC
Phone: 774-262-3754