MEDICARE: MR. DON CHARLES GRABER LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	980020	CO

General Provider Information

NPI Number	:	1487713731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DON CHARLES GRABER LCSW

Provider Business Mailing Address
First Line	:	1843 AUSTIN BLUFFS
Second Line	:	UNIVERSITY OFFICE PARK
City	:	COLO SPR
State	:	CO
Zip	:	80918
Country	:	US
Telephone Number	:	719-548-8484
Fax Number	:	719-548-8396

Provider Business Practice Location Address
First Line	:	1843 AUSTIN BLUFFS PARKWAY
Second Line	:
City	:	COLO SPR
State	:	CO
Zip	:	80918
Country	:	US
Telephone Number	:	719-548-8484
Fax Number	:	719-548-8396

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2006
Last Update Date	:	07/08/2007

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