Nichole D Graves, M.A., LPC, LADC/MH

Individual provider Active NPI Counselor · Cushing, OK

NPI 1497040968 · NPPES record last updated Apr 28, 2022

Key facts

NPI
1497040968
Entity type
Individual (NPI type 1)
Primary specialty
Counselor 101Y00000X
License
5025 (OK)
Practice address
1442 E Oak St
Cushing, OK 74023-3644
Phone
(918) 285-0947
Fax
(918) 376-0170
NPI assigned
Jun 13, 2011
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1065OKMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Graves Counseling and Wellbeing Group LLC Current
since Sep 8, 2015
Accepting new patients

Locations

1442 E Oak St
Cushing, OK 74023
Phone (918) 221-0896

321 E Main St
Cushing, OK 74023
Phone (918) 285-6268

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 1065 OK
Behavior Analyst 103K00000X
Counselor 101Y00000X 5025 OK Yes

Addresses

Primary practice location

1442 E Oak St
Cushing, OK 74023-3644

Mailing address

1442 E Oak St
Cushing, OK 74023-3644
Phone (918) 285-0947

Other identifiers

IdentifierTypeStateIssuer
200350220CMedicaidOK

Other providers in Cushing, OK

All providers in Cushing, OK · Counselor in Oklahoma

Sources for this page

Verify at the official NPI Registry.