Provider Demographics
NPI:1548693005
Name:CARINI-GRAVES, FAITH MARIE (PMHNP(PSYCHIATRIC))
Entity type:Individual
Prefix:MRS
First Name:FAITH
Middle Name:MARIE
Last Name:CARINI-GRAVES
Suffix:
Gender:F
Credentials:PMHNP(PSYCHIATRIC)
Other - Prefix:MRS
Other - First Name:FAITH
Other - Middle Name:MARIE
Other - Last Name:RIVERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PMHNP(PSYCHIATRIC)
Mailing Address - Street 1:1400 HOLLYHOCK DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-9797
Mailing Address - Country:US
Mailing Address - Phone:158-536-9246
Mailing Address - Fax:
Practice Address - Street 1:695 BAY RD.
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:NY
Practice Address - Zip Code:14580
Practice Address - Country:US
Practice Address - Phone:585-787-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-19
Last Update Date:2022-08-16
Deactivation Date:2022-07-15
Deactivation Code:
Reactivation Date:2022-08-10
Provider Licenses
StateLicense IDTaxonomies
NY312266164W00000X
NY404233363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse