Individual
LAVETTE GOODMAN GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1133 SOUTH BLVD APT 901, OAK PARK, IL 60302-4279
(201) 616-8181
Mailing address
1133 SOUTH BLVD APT 901, OAK PARK, IL 60302-4279
(201) 616-8181
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
041.472420
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209.032017
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
309.023545
IL
Other
Enumeration date
07/24/2022
Last updated
11/29/2025
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