Provider Demographics
NPI:1629760723
Name:CAROLE GRAYBILL LCSW PLLC
Entity Type:Organization
Organization Name:CAROLE GRAYBILL LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAYBILL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:708-254-6644
Mailing Address - Street 1:1024 NORTH BLVD STE 209
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1149
Mailing Address - Country:US
Mailing Address - Phone:708-254-6644
Mailing Address - Fax:
Practice Address - Street 1:1024 NORTH BLVD STE 209
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1149
Practice Address - Country:US
Practice Address - Phone:708-254-6644
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty