Provider Demographics
NPI:1922574680
Name:GRAHAM, ROBIN LARRICK (LCSW)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:LARRICK
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 N RIDING RD
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-2524
Mailing Address - Country:US
Mailing Address - Phone:406-270-3422
Mailing Address - Fax:
Practice Address - Street 1:286 5TH AVENUE EAST N
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-4119
Practice Address - Country:US
Practice Address - Phone:406-270-3422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-21
Last Update Date:2018-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical