Provider Demographics
NPI:1154318905
Name:GRAHAM, CHRISTIANE MARGARETE (LCSW-C)
Entity Type:Individual
Prefix:MS
First Name:CHRISTIANE
Middle Name:MARGARETE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4112 DECATUR AVE
Mailing Address - Street 2:
Mailing Address - City:KENSINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20895-1507
Mailing Address - Country:US
Mailing Address - Phone:301-949-2624
Mailing Address - Fax:301-946-0340
Practice Address - Street 1:13415 CONNECTICUT AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-2910
Practice Address - Country:US
Practice Address - Phone:301-949-2624
Practice Address - Fax:301-946-0340
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-05
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD108771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCF557-0001OtherFED BC/BS
MDQG14CMOtherCARE FIRST
DCF557-0001OtherFED BC/BS
MDQG14CMOtherCARE FIRST