Provider Demographics
NPI:1629880919
Name:TOLBERT, GRAHAM AUSTEN (LCMHCA, LCAS)
Entity type:Individual
Prefix:
First Name:GRAHAM
Middle Name:AUSTEN
Last Name:TOLBERT
Suffix:
Gender:M
Credentials:LCMHCA, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 ONTEORA BLVD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28803-1050
Mailing Address - Country:US
Mailing Address - Phone:828-367-7719
Mailing Address - Fax:828-820-5503
Practice Address - Street 1:802 FAIRVIEW RD OFC 4
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-1171
Practice Address - Country:US
Practice Address - Phone:828-367-7719
Practice Address - Fax:828-820-5503
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-23
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-28873101YA0400X
NCA21199101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty