Provider Demographics
NPI:1952811226
Name:GRAVES, LUCIE S (LCPC, LADC)
Entity Type:Individual
Prefix:
First Name:LUCIE
Middle Name:S
Last Name:GRAVES
Suffix:
Gender:F
Credentials:LCPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:336 MOUNT HOPE AVE STE 14
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-4236
Mailing Address - Country:US
Mailing Address - Phone:207-991-3310
Mailing Address - Fax:207-543-4666
Practice Address - Street 1:336 MOUNT HOPE AVE STE 14
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4236
Practice Address - Country:US
Practice Address - Phone:207-991-3310
Practice Address - Fax:207-573-4666
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-02
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC7968101YA0400X
MECC5029101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)