Provider Demographics
NPI:1316604267
Name:GRAVES, WHITNEY CYNTHIA (MED, LPC)
Entity type:Individual
Prefix:
First Name:WHITNEY
Middle Name:CYNTHIA
Last Name:GRAVES
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11335 EAGLE BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-4888
Mailing Address - Country:US
Mailing Address - Phone:713-824-3252
Mailing Address - Fax:
Practice Address - Street 1:11335 EAGLE BRANCH DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-4888
Practice Address - Country:US
Practice Address - Phone:713-824-3252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-25
Last Update Date:2021-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81691101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional