Provider Demographics
NPI:1396221503
Name:VANESSA GERMAN GRAVES COUNSELING & CONSULTATION SERVICES, LLC
Entity Type:Organization
Organization Name:VANESSA GERMAN GRAVES COUNSELING & CONSULTATION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INDIVIDUAL PRACTATIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VANESSA
Authorized Official - Middle Name:GERMAN
Authorized Official - Last Name:GRAVES
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW, PIP
Authorized Official - Phone:205-737-7678
Mailing Address - Street 1:521 ENERGY CENTER BLVD STE 1506
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35473-5833
Mailing Address - Country:US
Mailing Address - Phone:205-737-7678
Mailing Address - Fax:205-737-7681
Practice Address - Street 1:521 ENERGY CENTER BLVD STE 1506
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35473
Practice Address - Country:US
Practice Address - Phone:205-737-7678
Practice Address - Fax:205-737-7681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-11
Last Update Date:2023-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0996C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty