MISS KWANDA LEE GRAVES NPI 1508313628

NPI Information

  • NPI: 1508313628
  • Provider Name: MISS KWANDA LEE GRAVES
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 4401 PROVIDENCE LANE
    SUITE 121
    WINSTON-SALEM, NC
    ZIP 27106
  • Phone: (336) 896-1323

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NPI Details

MISS Kwanda Lee Graves is an addiction (substance use disorder) counselor in Winston-salem, NC. MISS Kwanda Lee Graves NPI is 1508313628. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4401 PROVIDENCE LANE
SUITE 121
WINSTON-SALEM, NC
ZIP 27106
Phone: (336) 896-1323
Fax: (336) 896-1327

The enumeration date for this NPI number is 9/7/2016 and was last updated on 9/7/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11598959660MEDICAIDNORTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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