Healthcare Provider Details

I. General information

NPI: 1689309890
Provider Name (Legal Business Name): KATIE LYNN GRAZIANO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2022
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2571 BAGLYOS CIR STE B29
BETHLEHEM PA
18020-8050
US

IV. Provider business mailing address

224 10TH ST
WEST EASTON PA
18042-5424
US

V. Phone/Fax

Practice location:
  • Phone: 610-628-2116
  • Fax: 610-535-8960
Mailing address:
  • Phone: 610-628-2116
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPC014180
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: