Provider Demographics
NPI:1508242389
Name:GRAHAM, ERIN (LCPAT, ATR-BC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:LCPAT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10703 LAMOKA LN
Mailing Address - Street 2:
Mailing Address - City:NEW MARKET
Mailing Address - State:MD
Mailing Address - Zip Code:21774-6891
Mailing Address - Country:US
Mailing Address - Phone:410-279-0380
Mailing Address - Fax:
Practice Address - Street 1:263 W PATRICK ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-6910
Practice Address - Country:US
Practice Address - Phone:301-276-4997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-04
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDATC122101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional