Provider Demographics
NPI:1144990219
Name:GRAHAM, REBECCA (LPC, LMFT)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11501 HURON LN
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72211-1846
Mailing Address - Country:US
Mailing Address - Phone:866-951-4325
Mailing Address - Fax:
Practice Address - Street 1:11501 HURON LN
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-1846
Practice Address - Country:US
Practice Address - Phone:866-951-4325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
P2411003101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional