Provider Demographics
NPI:1619300142
Name:QUICK-GRAHAM, LAUREN LUCILE (MSW)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:LUCILE
Last Name:QUICK-GRAHAM
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11010 LAKE GROVE BLVD STE 106
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-7391
Mailing Address - Country:US
Mailing Address - Phone:919-230-4572
Mailing Address - Fax:
Practice Address - Street 1:101 VISTA BROOKE DR
Practice Address - Street 2:
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-9713
Practice Address - Country:US
Practice Address - Phone:919-230-4572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-20
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0095741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical