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General NPI Number Information
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NPI Number | 1649624180
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Entity Type | Individual
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Provider Name | JESSICA MCGRAW LLPC, CAADC
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Gender | Female
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Dates
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Enumeration Date | 04/21/2016
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Last Update Date | 10/30/2017
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Provider Practice Location Address
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Address Line | 445 E STATE ST
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City | TRAVERSE CITY
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State | MI
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Zip | 49686-2603
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Country | US
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Telephone | 231-922-4810
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Fax | 231-943-2590
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Provider Business Mailing Address
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Address Line | 1010 S GARFIELD AVENUE
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City | TRAVERSE CITY
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State | MI
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Zip | 49686-3465
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Country | US
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Telephone | 231-346-5216
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Fax | 231-943-2590
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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 | 101YS0200X
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Taxonomy Name | School Counselor
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License Number | 6401016117
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6401016117
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 6401016117
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License Number State | MI
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