Provider Demographics
NPI:1518668086
Name:GRAUWILER, PEGGY A (PHD, LCSW)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:A
Last Name:GRAUWILER
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:353 NASSAU ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-4623
Mailing Address - Country:US
Mailing Address - Phone:917-208-4361
Mailing Address - Fax:
Practice Address - Street 1:353 NASSAU ST
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-4623
Practice Address - Country:US
Practice Address - Phone:917-208-4361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR071487-011041C0700X
NJ44SC061384001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical