Provider Demographics
NPI:1508545047
Name:HUSICK, GRAHAM CLAYTON (PSYD)
Entity type:Individual
Prefix:DR
First Name:GRAHAM
Middle Name:CLAYTON
Last Name:HUSICK
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1433 S FAIRMONT LOOP
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-8930
Mailing Address - Country:US
Mailing Address - Phone:425-698-9382
Mailing Address - Fax:
Practice Address - Street 1:1324 E SHERMAN AVE
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-4042
Practice Address - Country:US
Practice Address - Phone:208-244-0290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-12
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID3671779103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical