Provider Demographics
NPI:1083604805
Name:GRABILL, MICHAEL L (MED LPC LAC CAADC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:L
Last Name:GRABILL
Suffix:
Gender:M
Credentials:MED LPC LAC CAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 WINDMILL HL STE 1
Mailing Address - Street 2:
Mailing Address - City:BURNHAM
Mailing Address - State:PA
Mailing Address - Zip Code:17009-1837
Mailing Address - Country:US
Mailing Address - Phone:717-994-4483
Mailing Address - Fax:
Practice Address - Street 1:20 WINDMILL HL STE 1
Practice Address - Street 2:
Practice Address - City:BURNHAM
Practice Address - State:PA
Practice Address - Zip Code:17009-1837
Practice Address - Country:US
Practice Address - Phone:717-994-4483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-24
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1279101YA0400X
CO170101YA0400X
CO5825101YP2500X
PAPC000823101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA25181400304OtherMHSA
PA50048419OtherMHSA
PA2106622OtherMHSA
PA410141OtherMHSA