Active NPI
Anthony Graham, B.S
- Social Worker
- Detroit, MI
National Provider Identifier
1154632404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 6803086243
- Practice address
- 1700 Waterman St
Detroit, MI 48209-2022 - Phone
- (313) 963-2266
- Fax
- (313) 963-2471
- NPI assigned
- Jul 1, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6803086243 | MI | Primary |
Addresses
Primary practice location
1700 Waterman St
Detroit, MI 48209-2022
Mailing address
19329 Ardmore St
Detroit, MI 48235-1704
Phone (313) 963-2266
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
- Credentials
- Bachelor of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6803086243 | MI | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277942400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277942400000",
"number": "1154632404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19329 ARDMORE ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482351704",
"telephone_number": "313-963-2266",
"fax_number": "313-963-2471"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 WATERMAN ST",
"city": "DETROIT",
"state": "MI",
"postal_code": "482092022",
"telephone_number": "313-963-2266",
"fax_number": "313-963-2471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "ANTHONY",
"credential": "B.S",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-07-01",
"last_updated": "2010-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6803086243",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.