Provider Demographics
NPI:1376932533
Name:GRABER, MINDY (MS, LMHC)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:
Last Name:GRABER
Suffix:
Gender:F
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 MARINE DR. NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98271
Mailing Address - Country:US
Mailing Address - Phone:360-716-4058
Mailing Address - Fax:
Practice Address - Street 1:2321 MARINE DR. NE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:WA
Practice Address - Zip Code:98271
Practice Address - Country:US
Practice Address - Phone:360-716-4058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-12
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX70766101YP2500X
WALH60805758101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional