Provider Demographics
NPI:1003545807
Name:GRAF, MELISSA MARIE BOISVERT (LCSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE BOISVERT
Last Name:GRAF
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E DAVIE ST STE 140
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27601-2093
Mailing Address - Country:US
Mailing Address - Phone:919-514-3566
Mailing Address - Fax:
Practice Address - Street 1:44 HILLSBORO ST
Practice Address - Street 2:#44C
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312
Practice Address - Country:US
Practice Address - Phone:919-514-3566
Practice Address - Fax:919-516-0057
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0119241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical