Individual
LACEY MARIE GRAFFAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., LCPC
Contact information
Practice address
63 OCEAN ST UNIT B, SOUTH PORTLAND, ME 04106-2828
(207) 432-4007
(207) 774-9299
Mailing address
175 DEER CROSSING RD, LIMERICK, ME 04048-3418
(207) 432-4007
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
CC6373
ME
101YM0800X
Mental Health Counselor
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710494315
—
ME
Enumeration date
01/04/2018
Last updated
02/15/2024
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