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Individual
MR. MARSHALL GUILBERT GRAVELY
Active
Individual
MR. MARSHALL GUILBERT GRAVELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C002471
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235247628
TRICARE
NC
01
—
132MR
BCBS
NC
01
—
191052
MEDCOST
NC
01
—
2327208
CIGNA
NC
05
—
6003651
—
NC
Enumeration date
08/27/2006
Last updated
10/21/2019
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