Healthcare Provider Details

I. General information

NPI: 1669183570
Provider Name (Legal Business Name): SARAH ELIZABETH GRAHAM LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/12/2022
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 W GROVE ST STE G
MIDDLEBORO MA
02346-1462
US

IV. Provider business mailing address

205 W GROVE ST STE G
MIDDLEBORO MA
02346-1462
US

V. Phone/Fax

Practice location:
  • Phone: 774-357-6294
  • Fax: 508-699-0963
Mailing address:
  • Phone: 774-357-6294
  • Fax: 508-699-0963

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHC10006419
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: