MR. GREGORY KIRBY INGRAHAM (NPI# 1871780700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1871780700 |
Entity Type | Individual |
Full Name | MR. GREGORY KIRBY INGRAHAM |
Credential | MSW, LCSW |
Practice Address |
1150 Route 54 W Clinton IL 61727-2148 |
Mailing Address |
Po Box 616 Clinton IL 61727-0616 |
Practice Telephone | 2179359496 |
Practice Fax Number | 2179354508 |
Mailing Telephone | 2179352788 |
Mailing Fax Number | 2179354508 |
Enumeration Date | 2007-09-25 |
Last Update Date | 2007-09-25 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
IL | Behavioral Health & Social Service Providers | |
Y | 101YM0800X |
Counselor Specialization: Mental Health |
IL | Behavioral Health & Social Service Providers |
Street Address |
1150 ROUTE 54 W |
City | CLINTON |
State | IL |
Zip Code | 61727-2148 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891981460 | Erin Lee White-fish | Counselor | 1150 Route 54 W, Clinton, IL 61727-2148 | 2007-09-18 |
1215160049 | Dewitt County Human Resource Center | Clinic/Center | 1150 Route 54 W, Clinton, IL 61727-2148 | 2009-08-27 |
1225266026 | Courtney M Lee | Student in an Organized Health Care Education/Training Program | 1150 Route 54 W, Clinton, IL 61727-2148 | 2009-06-30 |
1497983290 | Scott R Zaehler | Student in an Organized Health Care Education/Training Program | 1150 Route 54 W, Clinton, IL 61727-2148 | 2009-06-30 |
1578700886 | Bruce C Butler | Case Manager/Care Coordinator | 1150 Route 54 W, Clinton, IL 61727-2148 | 2009-01-09 |
1598921611 | Sara Jane Duffy | Student in an Organized Health Care Education/Training Program | 1150 Route 54 W, Clinton, IL 61727-2148 | 2008-07-29 |
1891975850 | Kevin Edward Hegi | Student in an Organized Health Care Education/Training Program | 1150 Route 54 W, Clinton, IL 61727-2148 | 2007-11-07 |
1730378720 | Katherine Ann Adler | Student in an Organized Health Care Education/Training Program | 1150 Route 54 W, Clinton, IL 61727-2148 | 2007-10-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144692393 | Complete Wellness and Integrative Health Center Ltd | General Practice | 211 E Quincy St, Clinton, IL 61727 | 2015-10-28 |
1124247507 | Clinton Unit School District 15 | Local Education Agency (LEA) | 1210 State Route 54 West, Clinton, IL 61727 | 2007-04-24 |
1578600615 | Dewitt County Human Resource Center | Clinic/Center | 1150 Rt 54 West, Clinton, IL 61727 | 2007-01-30 |
1164569265 | Kara Lynn Johnson | Case Manager/Care Coordinator | 1150 Route 54 West, Clinton, IL 61727 | 2007-01-30 |
1659474328 | Highland Park Cvs, L.L.C. | Pharmacy | 60 Clinton Plz Sc, Clinton, IL 61727 | 2006-09-07 |
1528095510 | St. Joseph Medical Center | Nurse Practitioner | 1231 Kleeman Dr., Clinton, IL 61727 | 2006-06-27 |
1588652044 | Residential Alternatives of Illinois Inc | Skilled Nursing Facility | 1 Park Lane West, Clinton, IL 61727 | 2005-10-10 |
1629218466 | Olympian Surgical Suites LLC | Clinic/Center | 803 Illini Dr, Clinton, IL 61727 | 2009-03-05 |
1023238920 | Sara Ann Holmes | Case Manager/Care Coordinator | 1150 Route 54 West, Clinton, IL 61727 | 2007-04-26 |
1740327881 | Cory William Baxter | Counselor | 1150 Route 54 West, Clinton, IL 61727 | 2007-01-30 |
Find all providers in zip 61727 |
Taxonomy Code | 101YM0800X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Counselor |
Specialization | Mental Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144832882 | Lativia S Brown | Counselor | 9500 Baymar Ct, Clinton, MD 20735-3399 | 2020-08-22 |
1013570449 | Jennifer Marie Bartkowiak | Counselor | 2 Williams St Ste 1, Clinton, NY 13323-1748 | 2019-04-22 |
1295290609 | Alexis Marie Coleman | Counselor | 205 Shields St, Clinton, NC 28328-3241 | 2019-02-11 |
1225592140 | India Alexis Kea | Counselor | 9015 Woodyard Rd Ste 210, Clinton, MD 20735-4209 | 2019-01-24 |
1477045995 | Dynamic Psychological & Mediation Services | Counselor | 104 S 7th St, Clinton, OK 73601 | 2018-05-31 |
1831688233 | Jed Black | Counselor | 1407 N 2000 W Ste J, Clinton, UT 84015-8563 | 2018-05-02 |
1093214116 | Amy Elizabeth Glaser | Counselor | 40 Fairview Ave, Clinton, NJ 08809-1330 | 2018-02-04 |
1437662509 | Nancy Anne Baumgartner | Counselor | 65 Old Highway 22 Ste 7b, Clinton, NJ 08809-1315 | 2017-11-13 |
1356868236 | Gwendolyn Blake | Counselor | 65 Old Rt. 22, Suite 7b, Clinton, NJ 08809 | 2017-08-23 |
1497282743 | Sharon Vessel | Counselor | 10105 Plank Road Suite A, Clinton, LA 70722 | 2017-05-17 |
Find all providers in CLINTON |
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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.