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General NPI Number Information
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NPI Number | 1306703483
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Entity Type | Organization
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Legal Business Name | CHARLIE WILLIAM L.L.C.
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Dates
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Enumeration Date | 01/08/2026
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Last Update Date | 01/08/2026
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Provider Practice Location Address
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Address Line | 27 HADLEY RD APT 175
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City | SUNDERLAND
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State | MA
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Zip | 01375-9531
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Country | US
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Telephone | 224-374-6717
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Fax |
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Provider Business Mailing Address
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Address Line | 145 TREMONT ST STE 201-1560
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City | BOSTON
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State | MA
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Zip | 02111-1208
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Country | US
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Telephone | 224-374-6717
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | MR. WILLIAM CHARLES GRACIK JR.
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Credential | LMHC
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Telephone | 224-374-6717
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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