Provider Demographics
NPI:1336998822
Name:DIEHL, GRACEANN (LPC)
Entity type:Individual
Prefix:
First Name:GRACEANN
Middle Name:
Last Name:DIEHL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5215 US HIGHWAY 15
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:PA
Mailing Address - Zip Code:17752-9031
Mailing Address - Country:US
Mailing Address - Phone:717-635-5089
Mailing Address - Fax:717-635-5089
Practice Address - Street 1:27 RANDOLPH RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:NJ
Practice Address - Zip Code:07731-8611
Practice Address - Country:US
Practice Address - Phone:718-506-1115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC017090101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional