MR. Gregory Kirby Ingraham, MSW, LCSW

NPI #1871780700 in Clinton, Illinois

Provider Information

NPI Number: 1871780700
Entity Type: Individual
Name: MR. Gregory Kirby Ingraham, MSW, LCSW
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Counselor - Mental Health
Credential: MSW, LCSW
Enumeration Date: Sep 25, 2007
Last Updated: Sep 25, 2007

Practice Location

Address: 1150 ROUTE 54 W
City: Clinton
State: Illinois
ZIP Code: 61727-2148
Phone: (217) 935-9496

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Mental Health — Mental Health	101YM0800X	Primary

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