Healthcare Provider Details

I. General information

NPI: 1811821077
Provider Name (Legal Business Name): MINDY GRAVES LMSW, CSW INTERN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4538 W CRAIG RD STE 290
NORTH LAS VEGAS NV
89032-2511
US

IV. Provider business mailing address

4538 W CRAIG RD STE 290
NORTH LAS VEGAS NV
89032-2511
US

V. Phone/Fax

Practice location:
  • Phone: 702-486-5659
  • Fax: 702-486-5630
Mailing address:
  • Phone: 702-486-5659
  • Fax: 702-486-5630

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberIC-3070
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: