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General NPI Number Information
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NPI Number | 1790706729
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Entity Type | Individual
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Provider Name | ANDREW JAMES GRAHAM LPC
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Gender | Male
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 10/16/2007
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Provider Practice Location Address
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Address Line | 2215 LANGHORNE RD SUITE 102-B
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City | LYNCHBURG
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State | VA
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Zip | 24501-1121
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Country | US
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Telephone | 434-948-4831
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Fax | 434-948-4855
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Provider Business Mailing Address
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Address Line | 111 BERKSHIRE PL
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City | LYNCHBURG
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State | VA
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Zip | 24502-2138
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Country | US
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Telephone | 434-237-0270
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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 | 4639
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License Number State | SC
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