Healthcare Provider Details

I. General information

NPI: 1629996657
Provider Name (Legal Business Name): GRACE CARAVETTA PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 L ST NW STE 430
WASHINGTON DC
20036-5748
US

IV. Provider business mailing address

3927 FAIR RIDGE DR STE 303
FAIRFAX VA
22033-2998
US

V. Phone/Fax

Practice location:
  • Phone: 667-668-2566
  • Fax:
Mailing address:
  • Phone: 845-915-0901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024197575
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: