Provider Demographics
NPI:1366849770
Name:GRAYMAN, CHARNA (MSW, LGSW)
Entity Type:Individual
Prefix:MRS
First Name:CHARNA
Middle Name:
Last Name:GRAYMAN
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2405 LIGHTFOOT DR
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-1533
Mailing Address - Country:US
Mailing Address - Phone:410-733-0481
Mailing Address - Fax:
Practice Address - Street 1:2405 LIGHTFOOT DR
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-1533
Practice Address - Country:US
Practice Address - Phone:410-733-0481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD176961041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool