Provider Demographics
NPI:1457895955
Name:GRAHAM COLLINS INC.
Entity Type:Organization
Organization Name:GRAHAM COLLINS INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GRAHAM
Authorized Official - Middle Name:EDWARDS
Authorized Official - Last Name:COLLINS
Authorized Official - Suffix:I
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:541-951-3095
Mailing Address - Street 1:1600 TOLMAN CREEK RD
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520
Mailing Address - Country:US
Mailing Address - Phone:541-951-3095
Mailing Address - Fax:
Practice Address - Street 1:1600 TOLMAN CREEK RD
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520
Practice Address - Country:US
Practice Address - Phone:541-951-3095
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORC4005101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty