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General NPI Number Information
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NPI Number | 1962019570
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Entity Type | Individual
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Provider Name | DAVID GRAVES JR. CDCA
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Gender | Male
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Dates
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Enumeration Date | 09/28/2020
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 303 3RD AVE
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City | CHESAPEAKE
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State | OH
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Zip | 45619-1144
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Country | US
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Telephone | 740-451-0415
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Fax | 800-480-7578
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Provider Business Mailing Address
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Address Line | 307 4TH ST E APT 1A
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City | SOUTH POINT
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State | OH
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Zip | 45680-8456
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Country | US
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Telephone | 740-709-2210
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDCA.174405
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License Number State | OH
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