Individual
MRS. TIFFANY MICHELLE GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, LCMHC-A, LCAS-A
Contact information
Practice address
3545 WHITEHALL PARK DR STE 300, CHARLOTTE, NC 28273-4179
(980) 302-8850
(704) 316-8118
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
16081
NC
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCAS-21224
NC
101YP2500X
Professional Counselor
A16081
NC
Other
Enumeration date
07/12/2018
Last updated
08/12/2022
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