=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669310793
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | INNERCHANGE COUNSELING & CONSULTATION SERVICES, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/23/2026
-----------------------------------------------------
Last Update Date | 03/23/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9820 NORTHCROSS CENTER CT STE 73
-----------------------------------------------------
City | HUNTERSVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28078-7357
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-893-1865
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9820 NORTHCROSS CENTER CT STE 73
-----------------------------------------------------
City | HUNTERSVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28078-7357
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 704-893-1865
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PSYCHOTHERAPIST
-----------------------------------------------------
Name | DR. DAVID MARK GRAHAM
-----------------------------------------------------
Credential | LCMHC
-----------------------------------------------------
Telephone | 704-893-1865
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------