MEDICARE: MELISSA GRAGERT LPC

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	101Y00000X	Counselor	PRC13871	DC

General Provider Information

NPI Number	:	1992811129
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA GRAGERT LPC

Provider Business Mailing Address
First Line	:	4335 WISCONSIN AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20016-2148
Country	:	US
Telephone Number	:	202-486-1472
Fax Number	:	202-486-1472

Provider Business Practice Location Address
First Line	:	4335 WISCONSIN AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20016-2148
Country	:	US
Telephone Number	:	202-486-1472
Fax Number	:	202-486-1472

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

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	11/05/2013

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