Judy Brannan Graves, LCSW
Individual provider Active NPI Clinical Social Worker · Little Rock, AR
NPI 1114129178 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1114129178
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- C-102 (AR)
- Practice address
- 2401 Wentwood Valley Dr Apt 104
Little Rock, AR 72212-3651 - Phone
- (501) 225-6433
- Fax
- (501) 225-6433
- NPI assigned
- Jun 1, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-102 | AR | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | C-102 | AR | Yes |
Addresses
Primary practice location
2401 Wentwood Valley Dr Apt 104
Little Rock, AR 72212-3651
Mailing address
2401 Wentwood Valley Dr Apt 104
Little Rock, AR 72212-3651
Phone (501) 225-6433
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5S716 | Other | AR | BLUE CROSS - BLUE SHIELD |
Other providers in Little Rock, AR
- Briana Graves
- Crystal Janai' Graves
- Daniel W. Graves
- Emily C Graves
- Jenny R Graves
- Roy W. Graves
- Scott Graves
- Stephanie Graves
- Jennifer A Gravette
- Dominique Maurice Gray-Coats
All providers in Little Rock, AR · Clinical Social Worker in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.