Provider Demographics
NPI:1588727200
Name:GRAHAM, LURANA L (PHD, LCSW)
Entity type:Individual
Prefix:DR
First Name:LURANA
Middle Name:L
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:PHD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28631 S WESTERN AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:RANCHO PALOS VERDES
Mailing Address - State:CA
Mailing Address - Zip Code:90275-0816
Mailing Address - Country:US
Mailing Address - Phone:310-326-7766
Mailing Address - Fax:310-326-5712
Practice Address - Street 1:28631 S WESTERN AVE STE 107
Practice Address - Street 2:
Practice Address - City:RANCHO PALOS VERDES
Practice Address - State:CA
Practice Address - Zip Code:90275-0816
Practice Address - Country:US
Practice Address - Phone:310-326-7766
Practice Address - Fax:310-326-5712
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS3738, MFC8359101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAMFC8359OtherMARRIAGE & FAMILY THERAPI
CALCS3738OtherLICENSED CLINICAL SOCIAL
CALCS3738OtherLICENSED CLINICAL SOCIAL
CAMFC8359OtherMARRIAGE & FAMILY THERAPI