Active NPI
Shelly Denae Graf, LICSW
- Clinical Social Worker
- Maple Grove, MN
National Provider Identifier
1306197751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 18936
- Practice address
- 13024 89TH Ave N
Maple Grove, MN 55369-9513 - Phone
- (612) 306-4575
- Fax
- (763) 271-2707
- NPI assigned
- Sep 25, 2012
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 18936 | MN | Primary |
Addresses
Primary practice location
13024 89TH Ave N
Maple Grove, MN 55369-9513
Mailing address
13024 89TH Ave N
Maple Grove, MN 55369-9513
Phone (612) 306-4575
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 |
|---|---|---|---|
| 18936 | MN | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Right Response LLC | Past | Accepting new patients | |
| Edify Youth | Clinical | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Osseo, MN
- NPI 1689197782
-
- Clinical Social Worker
- Crystal, MN
- NPI 1477895985
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348531200000",
"number": "1306197751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13024 89TH AVE N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553699513",
"telephone_number": "612-306-4575",
"fax_number": "763-271-2707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13024 89TH AVE N",
"city": "MAPLE GROVE",
"state": "MN",
"postal_code": "553699513",
"telephone_number": "612-306-4575",
"fax_number": "763-271-2707"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAF",
"first_name": "SHELLY",
"middle_name": "DENAE",
"credential": "LICSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-25",
"last_updated": "2012-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MN",
"license": "18936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Maple Grove, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.