Provider Demographics
NPI:1982070488
Name:GRAVES, BREANNA R (LPC)
Entity type:Individual
Prefix:
First Name:BREANNA
Middle Name:R
Last Name:GRAVES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6909 S HOLLY CIR STE 304
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-1045
Mailing Address - Country:US
Mailing Address - Phone:720-729-7372
Mailing Address - Fax:720-202-1681
Practice Address - Street 1:6909 S HOLLY CIR STE 304
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-1045
Practice Address - Country:US
Practice Address - Phone:720-729-7372
Practice Address - Fax:720-202-1681
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0014729101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional