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Organization

GRAVES COUNSELING AND WELLBEING GROUP LLC

Active
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Organization

GRAVES COUNSELING AND WELLBEING GROUP LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICHOLE D GRAVES LPC, LADC/MH (OWNER)
(918) 285-0947
Entity
Organization

Contact information

Practice address
1442 E OAK ST, CUSHING, OK 74023-3644
(918) 285-6268
(918) 376-0170
Mailing address
1442 E OAK ST, CUSHING, OK 74023-3644
(918) 285-6268
(918) 376-0170

Taxonomy

Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
5025, 1065
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200536300A
OK
05
200536300B
OK
Enumeration date
04/10/2014
Last updated
04/28/2022
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