Healthcare Provider Details

I. General information

NPI: 1568389369
Provider Name (Legal Business Name): IMANI GRAHAM-HELLAMS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 BLACK OAK CT
CLAYTON NC
27520-3082
US

IV. Provider business mailing address

133 BLACK OAK CT
CLAYTON NC
27520-3082
US

V. Phone/Fax

Practice location:
  • Phone: 908-922-1919
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC200004682
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC019390
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: