Provider Demographics
NPI:1073883005
Name:BELHAM, JENNIFER GRAVES (LCMHC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:GRAVES
Last Name:BELHAM
Suffix:
Gender:F
Credentials:LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 WALNUT ST STE 8
Mailing Address - Street 2:
Mailing Address - City:WAYNESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28786-3246
Mailing Address - Country:US
Mailing Address - Phone:828-316-1708
Mailing Address - Fax:828-484-4452
Practice Address - Street 1:28 WALNUT ST STE 8
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-3246
Practice Address - Country:US
Practice Address - Phone:828-316-1708
Practice Address - Fax:828-484-4452
Is Sole Proprietor?:No
Enumeration Date:2012-01-06
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9252101YP2500X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional