Provider Demographics
NPI:1235694035
Name:GRAVES-DRAYTON, KENISHA (MA, LPC)
Entity Type:Individual
Prefix:
First Name:KENISHA
Middle Name:
Last Name:GRAVES-DRAYTON
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:KENISHA
Other - Middle Name:
Other - Last Name:GRAVES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11201 VETERANS MEMORIAL DR APT 2103
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77067-1151
Mailing Address - Country:US
Mailing Address - Phone:832-989-8042
Mailing Address - Fax:
Practice Address - Street 1:2300 GESSNER RD # 203
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-5006
Practice Address - Country:US
Practice Address - Phone:713-412-6646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-05
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75666101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health