Provider Demographics
NPI:1457906125
Name:GRAVES, JULIETA PAULINA (LPC)
Entity Type:Individual
Prefix:
First Name:JULIETA
Middle Name:PAULINA
Last Name:GRAVES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JULIETA
Other - Middle Name:PAULINA
Other - Last Name:FLORES HERNANDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:42881 SANDHURST CT
Mailing Address - Street 2:
Mailing Address - City:BROADLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:20148-4537
Mailing Address - Country:US
Mailing Address - Phone:703-939-4732
Mailing Address - Fax:
Practice Address - Street 1:42881 SANDHURST CT
Practice Address - Street 2:
Practice Address - City:BROADLANDS
Practice Address - State:VA
Practice Address - Zip Code:20148-4537
Practice Address - Country:US
Practice Address - Phone:703-939-4732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-08
Last Update Date:2021-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007943101YP2500X
DCPRC14844101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional