Provider Demographics
NPI:1346906161
Name:GRAHAM, VICTORIA ALEJANDRA (LPC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ALEJANDRA
Last Name:GRAHAM
Suffix:
Gender:
Credentials:LPC
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:GRAHAM
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:8222 S 48TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85044-5303
Mailing Address - Country:US
Mailing Address - Phone:520-640-7189
Mailing Address - Fax:866-900-9080
Practice Address - Street 1:8222 S 48TH ST STE 200
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-5303
Practice Address - Country:US
Practice Address - Phone:520-640-7189
Practice Address - Fax:866-900-9080
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-16
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-23518101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health