Provider Demographics
NPI:1124448808
Name:GRACHIS, NORMAN VICTOR
Entity type:Individual
Prefix:
First Name:NORMAN
Middle Name:VICTOR
Last Name:GRACHIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13237 NW 173RD LANE
Mailing Address - Street 2:
Mailing Address - City:ALACHUA
Mailing Address - State:FL
Mailing Address - Zip Code:32615
Mailing Address - Country:US
Mailing Address - Phone:352-215-6285
Mailing Address - Fax:
Practice Address - Street 1:13237 NW 173RD LANE
Practice Address - Street 2:
Practice Address - City:ALACHUA
Practice Address - State:FL
Practice Address - Zip Code:32615
Practice Address - Country:US
Practice Address - Phone:352-215-6285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL1124448808Medicaid