Provider Demographics
NPI:1386961910
Name:GRAVES, KAREN LARKINS (LPCC-S, LICDC)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:LARKINS
Last Name:GRAVES
Suffix:
Gender:F
Credentials:LPCC-S, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 18449
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44118-0449
Mailing Address - Country:US
Mailing Address - Phone:216-224-5116
Mailing Address - Fax:
Practice Address - Street 1:30841 EUCLID AVE # 201202
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-3100
Practice Address - Country:US
Practice Address - Phone:440-516-0281
Practice Address - Fax:440-494-7756
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-21
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH081194101YA0400X
OHE0600098101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1844944118Medicare PIN