Provider Demographics
NPI:1467724823
Name:GRAHAM-MCNEILL, EVELYN DELOIS (LCAS)
Entity Type:Individual
Prefix:MRS
First Name:EVELYN
Middle Name:DELOIS
Last Name:GRAHAM-MCNEILL
Suffix:
Gender:F
Credentials:LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 BYRDS POND RD
Mailing Address - Street 2:
Mailing Address - City:ERWIN
Mailing Address - State:NC
Mailing Address - Zip Code:28339-9012
Mailing Address - Country:US
Mailing Address - Phone:910-303-6982
Mailing Address - Fax:
Practice Address - Street 1:529 BYRDS POND RD
Practice Address - Street 2:
Practice Address - City:ERWIN
Practice Address - State:NC
Practice Address - Zip Code:28339-9012
Practice Address - Country:US
Practice Address - Phone:910-514-2911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-01
Last Update Date:2020-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1802101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)