Healthcare Provider Details

I. General information

NPI: 1396659553
Provider Name (Legal Business Name): ELEXUS GRAVES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3628 26TH STREET DR NE
HICKORY NC
28601-7206
US

IV. Provider business mailing address

173 GRADUATE LN APT 412
BOONE NC
28607-5858
US

V. Phone/Fax

Practice location:
  • Phone: 828-222-3749
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: