1487713731 NPI number — MR. DON CHARLES GRABER LCSW

Table of content: MR. DON CHARLES GRABER LCSW (NPI 1487713731)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487713731 NPI number — MR. DON CHARLES GRABER LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRABER
Provider First Name:
DON
Provider Middle Name:
CHARLES
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487713731
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1843 AUSTIN BLUFFS
Provider Second Line Business Mailing Address:
UNIVERSITY OFFICE PARK
Provider Business Mailing Address City Name:
COLO SPR
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80918
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-548-8484
Provider Business Mailing Address Fax Number:
719-548-8396

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1843 AUSTIN BLUFFS PARKWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLO SPR
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-548-8484
Provider Business Practice Location Address Fax Number:
719-548-8396
Provider Enumeration Date:
12/06/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  980020 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)