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Individual
MR. MARK GRAVES
Active
Individual
MR. MARK GRAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6801033930
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1036857
CIGNA #
MI
01
—
131428
COMPSYCH #
MI
01
—
P11126253
MULTIPLAN #
MI
Enumeration date
06/12/2006
Last updated
12/07/2009
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