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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