Jaclyn Ann Grajewski

Primary specialty

Social WorkerTaxonomy code 104100000X

License

LMSW-16046 Issued in AZ

Practice address

525 W Brown Rd
Mesa, AZ 85201-3202

Phone

(480) 684-8345

NPI assigned

Apr 16, 2019

Last updated

Apr 16, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jaclyn Ann Nieves Former name

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Banner Telehealth LLCGroup PAC ID 7113314279, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Banner Telehealth LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Scottsdale, AZ
  • NPI 1396492005
  Medicare reassignment Care Compare group NPD
• Banner Telehealth LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Tucson, AZ
  • NPI 1386352714
  NPD

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555372800000",
    "number": "1376106294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 W BROWN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013202",
            "telephone_number": "480-684-8345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 W BROWN RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852013202",
            "telephone_number": "480-684-8345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAJEWSKI",
        "first_name": "JACLYN",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2019-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AZ",
            "license": "LMSW-16046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "NIEVES",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David William Graham, DO
• Erin Graham
• Medorie Graham
• Megan R Graham
• Stephanie Lynn Graham, NMD
• Cindy Gramm
• Stephen Roger Grams, MA
• Molley Kay Granberry, PHARMD
• Corina Kay Grancorvitz, PHARMD
• Grand Canyon Home Care Inc. (grand canyon home care - MESA)

• Social Worker in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Social Worker in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.