Provider Demographics
NPI:1326197898
Name:GRACEY, HARRY LEWIS (DR)
Entity Type:Individual
Prefix:DR
First Name:HARRY
Middle Name:LEWIS
Last Name:GRACEY
Suffix:
Gender:M
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 DERBY ST
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-3741
Mailing Address - Country:US
Mailing Address - Phone:781-740-1522
Mailing Address - Fax:
Practice Address - Street 1:37 DERBY ST
Practice Address - Street 2:SUITE ONE
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-3741
Practice Address - Country:US
Practice Address - Phone:781-740-1522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA20476104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker