Individual
ANTHONY GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC
Contact information
Practice address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
Mailing address
7232 JUSTIN WAY, MENTOR, OH 44060-4881
(440) 578-8200
(216) 431-4151
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
C.1500356
OH
101YP2500X
Professional Counselor
C.1500356
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0270615
—
OH
Enumeration date
02/28/2017
Last updated
01/26/2021
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