Provider Demographics
NPI:1952786949
Name:GRAHAM, CHARLESCIE (LCSW, LCAS)
Entity type:Individual
Prefix:MS
First Name:CHARLESCIE
Middle Name:
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:LCSW, LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:364 SOMERSET DR
Mailing Address - Street 2:
Mailing Address - City:RAEFORD
Mailing Address - State:NC
Mailing Address - Zip Code:28376-5437
Mailing Address - Country:US
Mailing Address - Phone:919-679-2246
Mailing Address - Fax:
Practice Address - Street 1:364 SOMERSET DR
Practice Address - Street 2:
Practice Address - City:RAEFORD
Practice Address - State:NC
Practice Address - Zip Code:28376-5437
Practice Address - Country:US
Practice Address - Phone:919-679-2246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-20
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLCAS-21107101YA0400X
NCP0098471041C0700X
NCC0109781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)