Provider Demographics
NPI:1013387547
Name:GRAVES, LORRAINE MARGARET (PHD, MSW, LCSWA)
Entity Type:Individual
Prefix:DR
First Name:LORRAINE
Middle Name:MARGARET
Last Name:GRAVES
Suffix:
Gender:F
Credentials:PHD, MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1231 DOMINION OAK CIR
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-6956
Mailing Address - Country:US
Mailing Address - Phone:919-358-3991
Mailing Address - Fax:
Practice Address - Street 1:5315 HIGHGATE DR STE 102
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-6623
Practice Address - Country:US
Practice Address - Phone:919-418-1718
Practice Address - Fax:919-794-5715
Is Sole Proprietor?:No
Enumeration Date:2015-09-26
Last Update Date:2015-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0100221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical