Provider Demographics
NPI:1568642213
Name:GRAHAM, CARALYN L (LCPC)
Entity Type:Individual
Prefix:MS
First Name:CARALYN
Middle Name:L
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1850 OAK ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:NORTHFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60093-3042
Mailing Address - Country:US
Mailing Address - Phone:847-446-7924
Mailing Address - Fax:
Practice Address - Street 1:1850 OAK ST
Practice Address - Street 2:SUITE 250
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-3042
Practice Address - Country:US
Practice Address - Phone:847-446-7924
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-10
Last Update Date:2007-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional