Provider Demographics
NPI:1518002765
Name:GRAVES, JOHN FRANKLIN JR (LCPC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:FRANKLIN
Last Name:GRAVES
Suffix:JR
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:458 CHESTNUT DR
Mailing Address - Street 2:
Mailing Address - City:LUSBY
Mailing Address - State:MD
Mailing Address - Zip Code:20657-3268
Mailing Address - Country:US
Mailing Address - Phone:410-326-5056
Mailing Address - Fax:410-326-5056
Practice Address - Street 1:458 CHESTNUT DR
Practice Address - Street 2:
Practice Address - City:LUSBY
Practice Address - State:MD
Practice Address - Zip Code:20657-3268
Practice Address - Country:US
Practice Address - Phone:410-326-5056
Practice Address - Fax:410-326-5056
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC1651101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health