Provider Demographics
NPI:1225494008
Name:GRAHAM, ANNE B (MS ED, LMHC, NCC)
Entity Type:Individual
Prefix:MS
First Name:ANNE
Middle Name:B
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:MS ED, LMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 WINTON RD S
Mailing Address - Street 2:BLDG. 4, SUITE 303
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-3970
Mailing Address - Country:US
Mailing Address - Phone:585-473-7110
Mailing Address - Fax:585-473-3741
Practice Address - Street 1:2000 WINTON RD S
Practice Address - Street 2:BLDG. 4, SUITE 303
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-3970
Practice Address - Country:US
Practice Address - Phone:585-473-7110
Practice Address - Fax:585-473-3741
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-08
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006893-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health