Provider Demographics
NPI:1598153488
Name:GRAHAM, MEGHAN REBEKAH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:REBEKAH
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 SEVEN MILE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28714-8509
Mailing Address - Country:US
Mailing Address - Phone:828-675-4116
Mailing Address - Fax:
Practice Address - Street 1:116 SEVEN MILE RIDGE RD
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28714-8509
Practice Address - Country:US
Practice Address - Phone:828-675-4116
Practice Address - Fax:828-675-9312
Is Sole Proprietor?:No
Enumeration Date:2014-12-31
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA112261041C0700X
NCC0132651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1598153488Medicaid