Provider Demographics
NPI:1700638491
Name:ALICIA GRAHAM, PLLC
Entity Type:Organization
Organization Name:ALICIA GRAHAM, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC, NCC
Authorized Official - Phone:919-495-6469
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:919-495-6469
Mailing Address - Fax:919-957-9296
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-04
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty