Healthcare Provider Details

I. General information

NPI: 1487504825
Provider Name (Legal Business Name): SABYRN GRAVELY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2026
Last Update Date: 02/03/2026
Certification Date: 02/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

140 LARKSPUR LN
GALAX VA
24333-2752
US

IV. Provider business mailing address

107 ROBINSON ST
GALAX VA
24333-3221
US

V. Phone/Fax

Practice location:
  • Phone: 276-601-8464
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number0709025565
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: