Kelsey Rae Gravelle, SUDP LICSW
NPI 1952840944ActiveIndividual· Social Worker, Clinical· Longview, WA
Social Worker, Clinical (SUDP LICSW) with Cowlitz Indian Tribe, practicing in Longview, Washington. Enrolled in Medicare as practitioner - clinical social worker.
Overview
| NPI | 1952840944 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | SUDP LICSW |
| Sole proprietor | No |
| NPI issued | Feb 23, 2017 |
| Last updated in NPPES | May 8, 2025 |
| Certified by provider | May 8, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Social Worker, Clinical Primary | 1041C0700X | LW61677731 | WA |
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | CO60714593 | WA |
| Counselor | 101Y00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Social Worker (TX) |
|---|
Education and affiliations
| Graduation year | 2021 |
|---|---|
| Medicare specialty | Clinical Social Worker |
Medical group
- Cowlitz Indian TribeVancouver, WA · 27 clinicians
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