MR. ALL'WYN DALE GRAHAM (NPI# 1043519903) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043519903 |
| Entity Type | Individual |
| Full Name | MR. ALL'WYN DALE GRAHAM |
| Credential | NCC LPC SAP ADC |
| Practice Address |
4011 Meridian St Normal AL 35762-5312 |
| Mailing Address |
2251 Helton Dr Apt E5 Florence AL 35630-1084 |
| Practice Telephone | 2563724751 |
| Practice Fax Number | 2563725599 |
| Mailing Telephone | 2563488131 |
| Enumeration Date | 2011-03-17 |
| Last Update Date | 2012-12-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
524 | AL | Behavioral Health & Social Service Providers |
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
20238 | AL | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
2942 | AL | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SAP | 20238 | 01 | |
| AL | LPC | 2942 | 01 |
| Street Address |
4011 MERIDIAN ST |
| City | NORMAL |
| State | AL |
| Zip Code | 35762-5312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952731408 | Alabama A&m University | Clinic/Center | 4900 Meridian Stree, Normal, AL 35762 | 2013-11-20 |
| 1538413059 | Alabama A&m University | Clinic/Center | 4011 Meridian St., Huntsville, AL 35762 | 2012-11-06 |
| 1053676551 | Jessie Lee Zucnick-kimbugwe | Specialist/Technologist | 4900 Meridian St, Normal, AL 35762 | 2012-07-10 |
| 1083006829 | Brandon Allen Barnard | Specialist/Technologist | 4900 Meridian St Nw, Normal, AL 35762-7500 | 2015-03-03 |
| 1932753803 | Lakisha Duffie | Contractor | 4900 Meridian St Nw, Normal, AL 35762-7500 | 2019-07-30 |
| 1124531066 | Brandon Lyons | Specialist/Technologist | 4900 Meridian St Nw, Normal, AL 35762-7500 | 2017-11-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144820515 | Michelle Kurtyak | Pharmacist | 300 Greenbriar Dr # 1125, Normal, IL 61761-2278 | 2020-10-27 |
| 1932709433 | Children's Center for Dentistry | Dentist | 314 Susan Dr, Normal, IL 61761-6206 | 2020-10-26 |
| 1578162210 | Clair L Casagrande | Obstetrics & Gynecology | 1300 Franklin Ave Ste 330, Normal, IL 61761-4204 | 2020-10-23 |
| 1922606995 | Cassia Yuechun Weigel | Student in an Organized Health Care Education/Training Program | 601 N Main St Apt 5s, Normal, IL 61761-1576 | 2020-10-13 |
| 1912505157 | David Anthony Wesdock | Chiropractor | 208 Parkinson St, Normal, IL 61761-3079 | 2020-10-10 |
| 1578161865 | Abigail Hardesty | Nurse Practitioner | 201 Illinois State Univ, Normal, IL 61790-0001 | 2020-10-09 |
| 1245846989 | Susan M Carl | Nurse Practitioner | 201 North University Street, Normal, IL 61790-0001 | 2020-09-18 |
| 1629681796 | Brittany Nicole Mekley | Nurse Practitioner | 201 N. University, Normal, IL 61761 | 2020-08-28 |
| 1063024388 | Alyson Dyck | Physician Assistant | 2540 Health Services, Ssb Student Services Building, Normal, IL 61790-2540 | 2020-08-18 |
| 1710597372 | Lauren C Dilorenzo | Social Worker | 103 E Lincoln St Apt I, Normal, IL 61761-1450 | 2020-08-07 |
| Find all providers in NORMAL | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306499983 | Kimberly Adams | Counselor | 2000 N Linden St Apt N230, Normal, IL 61761-5384 | 2019-07-22 |
| 1114485158 | Metta Counseling | Counselor | 1100 Beech St Ste 7a, Normal, IL 61761-1499 | 2019-03-08 |
| 1417466517 | Karen Herzel | Counselor | 706 Oglesby Ave Ste 111, Normal, IL 61761-4616 | 2017-09-21 |
| 1245697119 | Lisa M Steve | Counselor | 819 Normal Ave, Normal, IL 61761-1531 | 2016-01-24 |
| 1225439342 | Jay L Cummins | Counselor | 706 Oglesby Ave Ste 112, Normal, IL 61761-4618 | 2014-09-08 |
| 1912296518 | Cynthia Rogers West | Counselor | 1119 Whitaker St, Normal, IL 61761-5756 | 2011-04-04 |
| 1851530018 | Horizons Counseling | Counselor | 1100 Beech St Ste 7, Normal, IL 61761-1456 | 2009-02-11 |
| 1588757413 | Thomas Winn Nylund | Counselor | 1015 Porter Ln, Normal, IL 61761-4215 | 2006-10-02 |
| 1346259140 | Patrick J. Carroll | Counselor | 405 Kays Dr, Normal, IL 61761-1979 | 2006-08-08 |
| 1376159657 | Jeffrey Graham | Counselor | 706 Oglesby Ave Ste 300, Normal, IL 61761-4616 | 2020-09-22 |
| Find all providers in NORMAL | ||||
Please comment or provide details below to improve the information on MR. ALL'WYN DALE GRAHAM.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.