Provider Demographics
NPI:1033481890
Name:GRAHAM, PAMELA PAGE (LCSW, LCAS, CSW)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:PAGE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:LCSW, LCAS, CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 FOX RIDGE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734
Mailing Address - Country:US
Mailing Address - Phone:910-818-1235
Mailing Address - Fax:828-631-9280
Practice Address - Street 1:338 FOX RIDGE CIRCLE
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734
Practice Address - Country:US
Practice Address - Phone:910-818-1235
Practice Address - Fax:828-631-9280
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-08
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0088201041C0700X
NCLCSWC008820101YM0800X
NCLCAS-23066101YM0800X
UTLCSW13302316-350101YM0800X
GACSW008515101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical