Provider Demographics
NPI:1245400464
Name:GRAVES, SHEILA (LICSW-C)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:
Last Name:GRAVES
Suffix:
Gender:F
Credentials:LICSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5354 SHERIFF RD
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-1308
Mailing Address - Country:US
Mailing Address - Phone:301-773-8201
Mailing Address - Fax:301-773-8203
Practice Address - Street 1:5354 SHERIFF RD
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-1308
Practice Address - Country:US
Practice Address - Phone:301-773-8201
Practice Address - Fax:301-773-8203
Is Sole Proprietor?:No
Enumeration Date:2008-03-04
Last Update Date:2008-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD133851041C0700X
DCLC3035321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical