Provider Demographics
NPI:1285853283
Name:GRAHAM, HELEN HALLUM (LCSW)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:HALLUM
Last Name:GRAHAM
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 1:1955 CLIFF VALLEY WAY NE
Mailing Address - Street 2:SUITE 215
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30329-2476
Mailing Address - Country:US
Mailing Address - Phone:404-633-4476
Mailing Address - Fax:404-636-9889
Practice Address - Street 1:1955 CLIFF VALLEY WAY NE
Practice Address - Street 2:SUITE 215
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329-2476
Practice Address - Country:US
Practice Address - Phone:404-633-4476
Practice Address - Fax:404-636-9889
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW17271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA80BBDKRMedicare ID - Type Unspecified
GANPP000Medicare UPIN