| Provider / Organization | NPI | Date Certified |
|---|---|---|
| AMANDA JEAN GRAHAM | 1356877245 | 2024-03-10 |
Amanda Jean Graham is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1356877245. Registration indicates Amanda Jean Graham is a provider of access to substance use disorder providers services with a specialization in Behavioral Health & Social Service Providers, Counselor (Behavioral Health & Social Service Providers, Counselor) (Counselor: Addiction (Substance Use Disorder),, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Counselor Addiction Substance Use Disorder, Behavioral Health & Social Service Providers) (Counselor, )
| Entity Type | Individual |
| Provider Name | Amanda Jean Graham MSBS, LCADC |
| Other Provider Name | Mandy Jean Graham |
| Practice Office Address | 100 DIECKS DR ELIZABETHTOWN, KY US |
| Practice Office Telephone | 5807262452 |
| Practice Office Fax | 5807262483 |
| Mailing Address | 100 DIECKS DR ELIZABETHTOWN, KY 427012443 US |
| Business Telephone | 2702381485 |
| Code | Practice | License No State |
|---|---|---|
| 101YA0400X PRIMARY | Access to Substance Use Disorder Providers Behavioral Health & Social Service Providers Counselor Behavioral Health & Social Service Providers Counselor Counselor: Addiction (Substance Use Disorder), Behavioral Health/Substance Abuse/Psychiatry Counselor Addiction Substance Use Disorder Behavioral Health & Social Service Providers Counselor | 291034
KY |