Provider Demographics
NPI:1710307509
Name:CHRISTY GRAHAM, LPC & ASSOCIATES LLC
Entity Type:Organization
Organization Name:CHRISTY GRAHAM, LPC & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST, PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTY
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:940-597-9635
Mailing Address - Street 1:1402 N CORINTH ST STE 116
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:TX
Mailing Address - Zip Code:76208-5445
Mailing Address - Country:US
Mailing Address - Phone:940-597-9635
Mailing Address - Fax:
Practice Address - Street 1:1402 N CORINTH ST STE 116
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:TX
Practice Address - Zip Code:76208-5445
Practice Address - Country:US
Practice Address - Phone:940-597-9635
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-21
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16563101YP2500X
101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty