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NPI Code Detail

MEDICARE: CHERYL MARIE GRAVITT LPC

MEDICARE: CHERYL MARIE GRAVITT LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorLPC014639GA
2101YP2500XProfessional Counselor008337GA

General Provider Information

NPI Number : 1689326688
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHERYL MARIE GRAVITT LPC
Provider Business Mailing Address
First Line : 4800 N SCOTTSDALE RD STE 2500
Second Line :
City : SCOTTSDALE
State : AZ
Zip : 85251-7630
Country : US
Telephone Number : 706-498-9560
Fax Number :
Provider Business Practice Location Address
First Line : 745 S MILLEDGE AVE STE 1A
Second Line :
City : ATHENS
State : GA
Zip : 30605-1292
Country : US
Telephone Number : 706-498-9560
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2022
Last Update Date : 10/01/2025

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Directions to “ CHERYL MARIE GRAVITT LPC” Practice Location

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