Individual provider Active NPI

Cynthia Lynn Grazioso, LMHC

  • Mental Health Counselor
  • Wellington, FL
National Provider Identifier
1356366603
Registry record updated Aug 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH4827 Issued in FL
Practice address
11120 S Crown Way Ste 1
Wellington, FL 33414-8718
Phone
(561) 419-6779
NPI assigned
Jul 13, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH4827 FL Primary

Addresses

Primary practice location

11120 S Crown Way Ste 1
Wellington, FL 33414-8718

Mailing address

8082 Tortuga LN
Boynton Beach, FL 33436-1738
Phone (561) 740-3953

Other practice location 1

2840 6th Ave S
Lake Worth, FL 33461-4729
Phone (561) 383-9800 ext. 1110

Other identifiers 1

IdentifierTypeStateIssuer
766909700MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MH4827FLMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1356366603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8082 TORTUGA LN",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334361738",
            "telephone_number": "561-740-3953",
            "fax_number": "561-740-9255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11120 S CROWN WAY STE 1",
            "city": "WELLINGTON",
            "state": "FL",
            "postal_code": "334148718",
            "telephone_number": "561-419-6779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2840 6th Ave S",
            "address_purpose": "LOCATION",
            "city": "Lake Worth",
            "state": "FL",
            "postal_code": "334614729",
            "country_code": "US",
            "telephone_number": "561-383-9800 x1110",
            "fax_number": "561-383-9851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAZIOSO",
        "first_name": "CYNTHIA",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-13",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH4827",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "766909700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellington, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.