Provider Demographics
NPI:1417479122
Name:GRAVES, SYLVIA CHRISTINE (LLBSW)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:CHRISTINE
Last Name:GRAVES
Suffix:
Gender:F
Credentials:LLBSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20435 BASIL ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48235-1629
Mailing Address - Country:US
Mailing Address - Phone:313-346-3610
Mailing Address - Fax:
Practice Address - Street 1:2925 RUSSELL
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48207
Practice Address - Country:US
Practice Address - Phone:313-396-5300
Practice Address - Fax:313-396-5353
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-13
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty