| Doctor Name: | MR. SHAWN EDWARD GRAHAM |
| NPI Number: | 1154665578 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LCPC |
| License Number: | CAC5036 |
| Business Practice Address: | 11 W Main St Fort Kent, ME - 047431271 |
| Business Phone Number: | 2078345430 |
| Business Fax Number: | 2078342332 |
| Mailing Address: | 1312 N Perley Brook Rd, FORT KENT |
| State: | ME |
| Postal Code: | 047431839 |
| Phone Number: | 2078345430 |
| Fax Number: | 2078342332 |
| NPI Enumeration Date: | 11/26/2012 |
| NPI Last Update Date: | 11/26/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | CAC5036 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | ME |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |