Provider Demographics
NPI:1497496004
Name:GRAHAM, CHRISTOPHER (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1566 S GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713-2638
Mailing Address - Country:US
Mailing Address - Phone:812-550-9219
Mailing Address - Fax:
Practice Address - Street 1:101 N PLAZA EAST BLVD STE 312
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-2871
Practice Address - Country:US
Practice Address - Phone:812-550-9219
Practice Address - Fax:812-901-6151
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34009322A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical