Healthcare Provider Details

I. General information

NPI: 1285049080
Provider Name (Legal Business Name): DAISHA ANICE GRAVES LMHC, M.ED.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DAISHA ANICE COHEN

II. Dates (important events)

Enumeration Date: 07/01/2014
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12 PADDOCK HILL DR
LAKEVILLE MA
02347-1233
US

IV. Provider business mailing address

12 PADDOCK HILL DR
LAKEVILLE MA
02347-1233
US

V. Phone/Fax

Practice location:
  • Phone: 774-218-6530
  • Fax:
Mailing address:
  • Phone: 774-218-6530
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10003210
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: