Provider Demographics
NPI:1568815124
Name:CYNTHIA GRAHAM COUNSELING
Entity Type:Organization
Organization Name:CYNTHIA GRAHAM COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COUNSLOR
Authorized Official - Prefix:
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:ELAINE
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:I
Authorized Official - Credentials:LCPC
Authorized Official - Phone:406-702-2309
Mailing Address - Street 1:1116 GRAND AVE
Mailing Address - Street 2:SUITE 301
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-4282
Mailing Address - Country:US
Mailing Address - Phone:406-702-2309
Mailing Address - Fax:
Practice Address - Street 1:1400 POLY DR
Practice Address - Street 2:SUITE 4E
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-1798
Practice Address - Country:US
Practice Address - Phone:406-252-4978
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-19
Last Update Date:2016-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTLCPC1530251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health