Provider Demographics
NPI:1659076768
Name:GRAVES, REBECCA LUCILLE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LUCILLE
Last Name:GRAVES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 ELMWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77520-2508
Mailing Address - Country:US
Mailing Address - Phone:713-854-4684
Mailing Address - Fax:
Practice Address - Street 1:704 ELMWOOD DR
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77520-2508
Practice Address - Country:US
Practice Address - Phone:713-854-4684
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-31
Last Update Date:2023-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81335101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty