Individual provider Active NPI

Carlos Devone Graham, MSW, LCSW

  • Clinical Social Worker
  • Savannah, GA
National Provider Identifier
1003148446
Registry record updated Feb 6, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C007323 Issued in NC
Practice address
321 Commercial Dr
Savannah, GA 31406-3662
Phone
(912) 961-5800
NPI assigned
Feb 10, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C007323 NC Primary

Addresses

Primary practice location

321 Commercial Dr
Savannah, GA 31406-3662

Mailing address

321 Commercial Dr
Savannah, GA 31406-3662
Phone (912) 961-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C007323NCMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517875200000",
    "number": "1003148446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 COMMERCIAL DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063662",
            "telephone_number": "912-961-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 COMMERCIAL DR",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063662",
            "telephone_number": "912-961-5800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "CARLOS",
        "middle_name": "DEVONE",
        "credential": "MSW, LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-10",
        "last_updated": "2018-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C007323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.