Provider Demographics
NPI:1467952531
Name:GRAZIANO, MELISSA (LPC, NCC, RPT, EMDR)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:GRAZIANO
Suffix:
Gender:F
Credentials:LPC, NCC, RPT, EMDR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 S HOWES ST STE A106
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80521-2871
Mailing Address - Country:US
Mailing Address - Phone:720-362-9429
Mailing Address - Fax:
Practice Address - Street 1:420 S HOWES ST STE A106
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80521-2871
Practice Address - Country:US
Practice Address - Phone:720-362-9429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-15
Last Update Date:2021-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0016300101Y00000X
CO0016563101YP2500X
COINTERN101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor