Deznique Graham

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P019174 Issued in NC

Practice address

5046 Grays Creek Church Rd
Hope Mills, NC 28348-7812

Phone

(910) 493-3555

Fax

(910) 493-3520

NPI assigned

Dec 23, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

A New Leaf Therapeutic Services, PLLCGroup PAC ID 0345567137, 6 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 and National Provider Directory roles.

• A New Leaf Therapeutic Services, PLLC

  • Clinical Social Worker
  • Fayetteville, NC
  • NPI 1710391867
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1671753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1447962246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5046 GRAYS CREEK CHURCH RD",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283487812",
            "telephone_number": "910-493-3555",
            "fax_number": "910-493-3520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5046 GRAYS CREEK CHURCH RD",
            "city": "HOPE MILLS",
            "state": "NC",
            "postal_code": "283487812",
            "telephone_number": "910-493-3555",
            "fax_number": "910-493-3520"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "920 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283035300",
            "country_code": "US",
            "telephone_number": "910-493-3555",
            "fax_number": "910-493-3520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "DEZNIQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-23",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P019174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elikem Kofi Gbeddy, M.D.
• Golden Opportunity Home, Inc
• Golden Opportunity Homes, Inc
• Jenny Debnam Gonzalez
• Tad Gow, RN
• Francisca Silva Graham, RN
• Great Expectations Mental Health Services, Inc.
• Green Beret Healthcare Agency, Inc
• Delisa Michelle Grimes
• Felicia Ann Grinie

• Clinical Social Worker in Hope Mills, NC
• Providers in Hope Mills, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2024; 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.