Basic Information
| Provider Information | |||||||||
| NPI: | 1164455457 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GRAHAM | ||||||||
| FirstName: | DEBBIE | ||||||||
| MiddleName: | |||||||||
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| Credential: | LPCC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | STORY | ||||||||
| OtherFirstName: | DEBBIE | ||||||||
| OtherMiddleName: | |||||||||
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| OtherCredential: | LPCC | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 130 SOUTHERN SCHOOL RD | ||||||||
| Address2: | |||||||||
| City: | SOMERSET | ||||||||
| State: | KY | ||||||||
| PostalCode: | 425013223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6066794782 | ||||||||
| FaxNumber: | 6066785296 | ||||||||
| Practice Location | |||||||||
| Address1: | 521 OLD HODGENVILLE RD | ||||||||
| Address2: | |||||||||
| City: | GREENSBURG | ||||||||
| State: | KY | ||||||||
| PostalCode: | 427439493 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2709323226 | ||||||||
| FaxNumber: | 2709325328 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/09/2006 | ||||||||
| LastUpdateDate: | 05/04/2017 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | 104401 | KY | Y | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.