Provider Demographics
NPI:1952921249
Name:GRAHAM, MOLLY ANN (LMHC, QS)
Entity type:Individual
Prefix:
First Name:MOLLY
Middle Name:ANN
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:LMHC, QS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2951 SW 22ND CIR # 26D
Mailing Address - Street 2:
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33445-7886
Mailing Address - Country:US
Mailing Address - Phone:561-279-5010
Mailing Address - Fax:
Practice Address - Street 1:1101 54TH ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33407-2419
Practice Address - Country:US
Practice Address - Phone:561-279-5010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-16
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17498101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health