Individual
KELSEY RAE GRAVELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDP LICSW
Contact information
Practice address
900 FIR ST, LONGVIEW, WA 98632-2544
(360) 575-3316
Mailing address
PO BOX 2429, LONGVIEW, WA 98632-8486
(360) 353-9422
(360) 423-7813
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
CO60714593
WA
1041C0700X
Clinical Social Worker
Primary
LW61677731
WA
Other
Enumeration date
02/23/2017
Last updated
05/08/2025
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