Healthcare Provider Details

I. General information

NPI: 1487487328
Provider Name (Legal Business Name): KELSA HOPE GRAYBILL MA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1869 CHARTER LN STE 200
LANCASTER PA
17601-5955
US

IV. Provider business mailing address

1869 CHARTER LN STE 200
LANCASTER PA
17601-5955
US

V. Phone/Fax

Practice location:
  • Phone: 717-806-5050
  • Fax: 717-806-5179
Mailing address:
  • Phone: 717-806-5050
  • Fax: 717-806-5179

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:
Title or Position:
Credential:
Phone: