Active NPI
Tiana Graham, LICSW
- Clinical Social Worker
- Boston, MA
National Provider Identifier
1104459544
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 123533
- Practice address
- 55 Fruit St
Boston, MA 02114-2621 - Phone
- (857) 296-5860
- NPI assigned
- Feb 13, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Clinical Social Worker | 1041C0700X | 123533 | MA | Primary |
Addresses
Primary practice location
55 Fruit St
Boston, MA 02114-2621
Mailing address
55 Fruit St
Boston, MA 02114-2621
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
| License | State | Type | Specialty |
|---|---|---|---|
| 123533 | MA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| General Hospital Corp | Current | Accepting new patients |
Locations
55 Fruit St
Boston, MA 02114
Interoperability endpoints
- graham.tiana.mgh@direct.partners.masshiway.net
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Boston, MA
- NPI 1508390014
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1581552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1701216000000",
"number": "1104459544",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 FRUIT ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142621"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FRUIT ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142621",
"telephone_number": "857-296-5860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "TIANA",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-13",
"last_updated": "2023-11-29",
"certification_date": "2023-10-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "123533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 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.