Provider Demographics
NPI:1437369642
Name:MAXEY, GRAHAM ALLAN (LPC)
Entity Type:Individual
Prefix:MR
First Name:GRAHAM
Middle Name:ALLAN
Last Name:MAXEY
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1304 W ABRAM ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-1711
Mailing Address - Country:US
Mailing Address - Phone:817-939-0800
Mailing Address - Fax:
Practice Address - Street 1:1304 W ABRAM ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-1711
Practice Address - Country:US
Practice Address - Phone:817-939-0800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7298101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional