Provider Demographics
NPI:1255724092
Name:GRAUSZ, CHARLES L (MED)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:L
Last Name:GRAUSZ
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13218 WRENN HOUSE LN
Mailing Address - Street 2:
Mailing Address - City:OAK HILL
Mailing Address - State:VA
Mailing Address - Zip Code:20171-3956
Mailing Address - Country:US
Mailing Address - Phone:703-643-3173
Mailing Address - Fax:
Practice Address - Street 1:13218 WRENN HOUSE LN
Practice Address - Street 2:
Practice Address - City:OAK HILL
Practice Address - State:VA
Practice Address - Zip Code:20171-3956
Practice Address - Country:US
Practice Address - Phone:703-643-3173
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-17
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701003964101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional