Margaret Graham

Individual provider Active NPI Professional Counselor · Lakewood, OH

NPI 1780006841 · NPPES record last updated Jan 9, 2014

Key facts

NPI
1780006841
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
E.0701150-SUPV (OH)
Practice address
12509 Madison Ave
Lakewood, OH 44107-5004
Phone
(216) 563-1754
Fax
(216) 563-1783
NPI assigned
Jan 9, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
E.0701150-SUPVOHMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X E.0701150-SUPV OH Yes

Addresses

Primary practice location

12509 Madison Ave
Lakewood, OH 44107-5004

Mailing address

12509 Madison Ave
Lakewood, OH 44107-5004
Phone (216) 563-1754

Other providers in Lakewood, OH

All providers in Lakewood, OH · Professional Counselor in Ohio

Sources for this page

Verify at the official NPI Registry.