Provider Demographics
NPI:1982036687
Name:GRAHAM, EMILIE ANNE (LCSW)
Entity type:Individual
Prefix:
First Name:EMILIE
Middle Name:ANNE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:EMILIE
Other - Middle Name:ANNE
Other - Last Name:ALLEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:4 WASHINGTON PL
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-6283
Mailing Address - Country:US
Mailing Address - Phone:720-451-2396
Mailing Address - Fax:
Practice Address - Street 1:4 WASHINGTON PL
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-6283
Practice Address - Country:US
Practice Address - Phone:720-451-2396
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-05
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO18601041C0700X
MT727471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical