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Organization
REVIZION COUNSELING SERVICES, PLLC
Active
Organization
REVIZION COUNSELING SERVICES, PLLC
Active
Other names
CHARLESCIE L GRAHAM
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHARLESCIE LEE GRAHAM LCSW, LCAS (CLINICIAN/OWNER)
(919) 679-2246
Entity
Organization
Contact information
Practice address
364 SOMERSET DR, RAEFORD, NC 28376-5437
(919) 679-2246
Mailing address
364 SOMERSET DR, RAEFORD, NC 28376-5437
(919) 679-2246
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2268448
SECRETARY OF STATE ID #
NC
Enumeration date
10/11/2021
Last updated
12/28/2023
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