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NPI Code Detail

MEDICARE: SHAWN GRAHAM LPC

MEDICARE: SHAWN GRAHAM LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor6401007096MI
2101YM0800XMental Health Counselor6401007096MI
3101YA0400XAddiction (Substance Use Disorder) Counselor6401007096MI

General Provider Information

NPI Number : 1033566674
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAWN GRAHAM LPC
Provider Business Mailing Address
First Line : 820 EDENBOUGH CIR APT 103
Second Line :
City : AUBURN HILLS
State : MI
Zip : 48326-4547
Country : US
Telephone Number : 248-464-2500
Fax Number :
Provider Business Practice Location Address
First Line : 1255 N OAKLAND BLVD
Second Line :
City : WATERFORD
State : MI
Zip : 48327-1545
Country : US
Telephone Number : 248-406-0090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2016
Last Update Date : 03/23/2026

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Directions to “ SHAWN GRAHAM LPC” Practice Location

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