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General NPI Number Information
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NPI Number | 1013836097
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Entity Type | Individual
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Provider Name | CHARISA BETH GRAHAM LPC-A
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Gender | Female
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Dates
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Enumeration Date | 07/13/2026
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Last Update Date | 07/13/2026
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Provider Practice Location Address
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Address Line | 3750 WILLIAM D TATE AVE
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City | GRAPEVINE
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State | TX
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Zip | 76051-7106
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Country | US
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Telephone | 817-421-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 8500 HARWOOD RD APT 2815
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76180-0410
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | TX
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