MISS KWANDA LEE GRAVES (NPI# 1508313628) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508313628 |
| Entity Type | Individual |
| Full Name | MISS KWANDA LEE GRAVES |
| Practice Address |
4401 Providence Lane Suite 121 Winston-salem NC 27106 |
| Mailing Address |
350 Teal Dr Winston Salem NC 27127-6812 |
| Practice Telephone | 3368961323 |
| Practice Fax Number | 3368961327 |
| Mailing Telephone | 3369182381 |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2016-09-07 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 1598959660 | 05 |
| Street Address |
4401 PROVIDENCE LANE SUITE 121 |
| City | WINSTON-SALEM |
| State | NC |
| Zip Code | 27106 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437799103 | Tyler Laura Lawrence | Behavioral Analyst | 1959 N Peace, 104, Winston-salem, NC 27106 | 2020-01-10 |
| 1316504624 | Amanda Baker | Behavior Technician | 1959 N Peace Haven Rd, Suite 104, Winston Salem, NC 27106 | 2019-05-22 |
| 1679030316 | Lavonda Williams | Behavior Technician | 1959 N Peace Haven Road, Winston Salem, NC 27106 | 2019-03-01 |
| 1518436708 | Angela Ruth Brown | Physical Therapy Assistant | 190 Moravian Way Drive, Winston-salem, NC 27106 | 2018-11-16 |
| 1407378896 | Applied Family Services of Winston-salem | Early Intervention Provider Agency | 4220 Witherow Rd, Winston Salem, NC 27106 | 2017-07-07 |
| 1750801676 | Julia Ann Horton | Speech-Language Pathologist | 2000 Salemtowne Drive, Winston Salem, NC 27106 | 2017-06-21 |
| 1124548037 | Tyler John Jones | Community Health Worker | 7014 Brandemere Ln. Apt F, Winston Salem, NC 27106 | 2017-06-21 |
| 1396274759 | Jennifer Cui | Social Worker | 3216 Cross Tree Rd, Winston-salem, NC 27106 | 2017-06-08 |
| 1063947802 | Rebecca Jeanette Mclemore | Social Worker | 4401 Providence Ln. #121, Top Priority Care Services, LLC., Winston-salem, NC 27106 | 2017-05-01 |
| 1720529357 | Rising Hope Clinical Assistance, LLC | Community/Behavioral Health | 510 Northgate Park Dr, Winston Salem, NC 27106 | 2017-03-15 |
| Find all providers in zip 27106 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790349728 | Nakia Carter | Counselor | 1o1o W. Northwest Boulevard, Winston-salem, NC 27101 | 2019-04-25 |
| 1528413952 | Nathaniel Wilson Jr. | Counselor | 1209 N. Highland Avenue, Winston-salem, NC 27101 | 2016-05-04 |
| 1801277421 | Rodney Parrish | Counselor | 725 Highland Avenue, 100, Winston-salem, NC 27101 | 2015-06-10 |
| 1306235700 | Makeba Larkin Casey | Counselor | 1066 W. 4th St, Suites 101, 201 & 202, Winston-salem, NC 27101 | 2015-01-22 |
| 1467603704 | Virginia H Mills | Counselor | 1066 W. 4th St., Suites 101, 201 & 202, Winston-salem, NC 27101 | 2008-10-06 |
| 1578945994 | Nathan Lee Tate | Counselor | 1066 W 4th St, Winston-salem, NC 27101 | 2015-06-22 |
| 1154543783 | Candace Peterson Davis | Counselor | 3821 Forrestgate Drive, Dba Forsyth Behavior Health, Winston-salem, NC 27103 | 2007-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841384 | Karen Yvette Johnson | Counselor | 2500 Saint Christopher Cir Sw Apt 1, Wilson, NC 27893-4474 | 2020-11-05 |
| 1407456163 | Fallon Middle Williams | Counselor | 127 Westview Meadows Dr, Goldsboro, NC 27530-9589 | 2020-10-30 |
| 1205436268 | Josette Hoffman Skinner | Counselor | 51 Park Dr Sw, Concord, NC 28027-7029 | 2020-10-29 |
| 1962002931 | Mind Over Mood | Counselor | 115 Carlos Drive, Garysburg, NC 27831 | 2020-10-29 |
| 1528668043 | Hope and Wellness Counseling Pllc | Counselor | 4017 S Nc Highway 11, Wallace, NC 28466-6111 | 2020-10-26 |
| 1205436730 | Joy Elise Chiles | Counselor | 8505 Mount Valley Ln, Raleigh, NC 27613-6931 | 2020-10-26 |
| 1588264006 | Jocelyn S Whitfield | Counselor | 1279 William Beale Rd, Pendleton, NC 27862-7015 | 2020-10-26 |
| 1225637796 | Cindy Verdoorn | Counselor | 10831 Pineville Rd Unit 9, Pineville, NC 28134-8137 | 2020-10-25 |
| 1700485430 | Travis William Richardson | Counselor | 3 Doctors Park Ste 3g, Asheville, NC 28801-4531 | 2020-10-23 |
| 1952900615 | Eastern Trauma & Recovery Counseling Service | Counselor | 11814 Us 64a, Spring Hope, NC 27882-9637 | 2020-10-22 |
| Find all providers with the same taxonomy | ||||
| City | WINSTON-SALEM |
| Zip Code | 27106 |
Please comment or provide details below to improve the information on MISS KWANDA LEE GRAVES.
| 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.