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Organization
SG WELLNESS MHC PLLC
Active
Organization
SG WELLNESS MHC PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHANI GRAVES MHC (OWNER)
(347) 475-1676
Entity
Organization
Contact information
Practice address
15 MACDONOUGH ST STE 3B, BROOKLYN, NY 11216-2303
(347) 475-1676
Mailing address
15 MACDONOUGH ST STE 3B, BROOKLYN, NY 11216-2303
(347) 475-1676
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1578990958
CIGNA
—
Enumeration date
07/18/2022
Last updated
07/18/2022
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