Healthcare Provider Details

I. General information

NPI: 1831684596
Provider Name (Legal Business Name): KAITLIN GRAFF LPCC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2018
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1212 TOD PL NW
WARREN OH
44485-2475
US

IV. Provider business mailing address

PO BOX 1212
WARREN OH
44482-1212
US

V. Phone/Fax

Practice location:
  • Phone: 330-469-6822
  • Fax: 330-294-5641
Mailing address:
  • Phone: 330-469-6822
  • Fax: 330-294-5641

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberE.1901552-SUPV
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.1901552-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: