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General NPI Number Information
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NPI Number | 1891183281
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Entity Type | Individual
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Provider Name | KATHERINE GRACZYK LPC
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Gender | Female
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Dates
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Enumeration Date | 01/07/2015
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Last Update Date | 02/09/2017
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Provider Practice Location Address
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Address Line | 1555 CONNECTICUT AVE NW SUITE 200-E
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City | WASHINGTON
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State | DC
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Zip | 20036-1111
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Country | US
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Telephone | 703-786-7882
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Fax |
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Provider Business Mailing Address
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Address Line | 1847 PATTON TER
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City | MC LEAN
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State | VA
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Zip | 22101-5314
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Country | US
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Telephone | 703-786-7882
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | A11237
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PRC14828
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License Number State | DC
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