Provider Demographics
NPI:1457360893
Name:GRAHAM, CHRISTY ANN (LPC)
Entity type:Individual
Prefix:MRS
First Name:CHRISTY
Middle Name:ANN
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CHRISTY
Other - Middle Name:ANN
Other - Last Name:DEMOUS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:1430 ROBINSON RD STE 430
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:TX
Mailing Address - Zip Code:76210-3155
Mailing Address - Country:US
Mailing Address - Phone:940-222-8703
Mailing Address - Fax:940-239-9867
Practice Address - Street 1:1430 ROBINSON RD STE 430
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:TX
Practice Address - Zip Code:76210-3155
Practice Address - Country:US
Practice Address - Phone:940-222-8703
Practice Address - Fax:940-239-9867
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2020-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16563101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141925102Medicaid