Individual
DANA AVALLONE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
180 WINGO WAY STE 306, MT PLEASANT, SC 29464
(843) 884-1777
(843) 884-0710
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
12632
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9223
MEDICARE GROUP PTAN
SC
05
—
SW1501
—
SC
Enumeration date
12/13/2013
Last updated
08/13/2025
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