Provider Demographics
NPI:1942071444
Name:GRACEFFO & GRACEFFO PSYCHOLOGY PLLC
Entity Type:Organization
Organization Name:GRACEFFO & GRACEFFO PSYCHOLOGY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GRACEFFO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:315-729-6215
Mailing Address - Street 1:37 HURD CIR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:NY
Mailing Address - Zip Code:13021-3026
Mailing Address - Country:US
Mailing Address - Phone:315-729-6215
Mailing Address - Fax:
Practice Address - Street 1:37 HURD CIR
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:NY
Practice Address - Zip Code:13021-3026
Practice Address - Country:US
Practice Address - Phone:315-729-6215
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-12
Last Update Date:2024-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty