Organization
JEM BEHAVIORAL HEALTH PLLC
Active
Other names
Vanessa Graham NP
Organization subpart
No
Provider details
NPI number
Authorized official
VANESSA GRAHAM FNP/PMHNP (OWNER)
(980) 483-3015
Entity
Organization
Contact information
Practice address
5960 FAIRVIEW RD STE 400, CHARLOTTE, NC 28210-3119
(704) 267-6905
Mailing address
5960 FAIRVIEW RD STE 400, CHARLOTTE, NC 28210-3119
(980) 483-3015
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
261QH0100X
Health Service Clinic/Center
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336693266
—
NC
Enumeration date
06/22/2021
Last updated
07/18/2022
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