MEDICARE: MS. KAREN LARKINS GRAVES LPCC-S, LICDC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YA0400X	Addiction (Substance Use Disorder) Counselor	081194	OH
2	101YP2500X	Professional Counselor	E0600098	OH

General Provider Information

NPI Number	:	1386961910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAREN LARKINS GRAVES LPCC-S, LICDC

Provider Business Mailing Address
First Line	:	PO BOX 18449
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44118-0449
Country	:	US
Telephone Number	:	216-224-5116
Fax Number	:

Provider Business Practice Location Address
First Line	:	30841 EUCLID AVE # 201202
Second Line	:
City	:	WILLOUGHBY
State	:	OH
Zip	:	44094-3100
Country	:	US
Telephone Number	:	440-516-0281
Fax Number	:	440-494-7756

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2010
Last Update Date	:	07/15/2024

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