Provider Demographics
NPI:1902021611
Name:GRAHAM, ALICIA MARIE (LCMHC, NCC)
Entity Type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:MARIE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:LCMHC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 HIDDEN SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27703-4921
Mailing Address - Country:US
Mailing Address - Phone:919-880-7422
Mailing Address - Fax:
Practice Address - Street 1:304 HIDDEN SPRINGS DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-4921
Practice Address - Country:US
Practice Address - Phone:919-495-6469
Practice Address - Fax:919-957-9296
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3003101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health