MEDICARE: COUNSELING OFFICES OF AMY S. GRAGERT, P.A.

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	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1881151819
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COUNSELING OFFICES OF AMY S. GRAGERT, P.A.

Provider Business Mailing Address
First Line	:	2610 STATE ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-2622
Country	:	US
Telephone Number	:	214-641-4545
Fax Number	:

Provider Business Practice Location Address
First Line	:	2610 STATE ST
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75204-2622
Country	:	US
Telephone Number	:	214-641-4545
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT/PSYCHOTHERAPIST
Name	:	AMY SUZANNE GRAGERT
Credential	:	MA,LPC-S, PA
Telephone Number	:	214-641-4545

Provider Enumeration Date	:	02/26/2019
Last Update Date	:	02/26/2019

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