Individual provider Active NPI

Elizabeth Graves, LCSW

  • Clinical Social Worker
  • Canton, GA
National Provider Identifier
1063178150
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CSW008548 Issued in GA
Practice address
714 Rockwood CT
Canton, GA 30115-0201
Phone
(615) 543-1488
NPI assigned
Nov 12, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X MSW009021 GA
Clinical Social Worker 1041C0700X CSW008548 GA Primary

Addresses

Primary practice location

714 Rockwood CT
Canton, GA 30115-0201

Mailing address

714 Rockwood CT
Canton, GA 30115-0201
Phone (615) 543-1488

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
MSW009021GAMDSocial Worker
CSW008548GAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1636675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1063178150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 ROCKWOOD CT",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301150201",
            "telephone_number": "615-543-1488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 ROCKWOOD CT",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301150201",
            "telephone_number": "615-543-1488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "ELIZABETH",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-12",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "GA",
            "license": "MSW009021",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW008548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2023; 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.