Provider Demographics
NPI:1558493015
Name:GRAHAM, MARY LORRAINE (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARY LORRAINE
Middle Name:
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
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Mailing Address - Street 1:3A BIRCH STREET
Mailing Address - Street 2:
Mailing Address - City:MENDHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07945-1303
Mailing Address - Country:US
Mailing Address - Phone:973-557-3027
Mailing Address - Fax:570-402-1144
Practice Address - Street 1:150 MOUNTAIN AVE
Practice Address - Street 2:SUITE 2-12 AFFILIATED PSYCHOTHERAPISTS, LLC
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2397
Practice Address - Country:US
Practice Address - Phone:973-557-3027
Practice Address - Fax:570-402-1144
Is Sole Proprietor?:No
Enumeration Date:2007-03-11
Last Update Date:2019-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC001805001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical