Andrea Graham

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

094835 Issued in NY

Practice address

1607 Route 300 Ste 115
Newburgh, NY 12550-1738

Phone

(845) 320-5942

NPI assigned

Jan 21, 2021

Last updated

Jun 30, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Access: Supports for Living Inc

  • Multi-Specialty Clinic/Center
  • Middletown, NY
  • NPI 1528174976

  Single Specialty

  Medicare reassignment NPD
• County of Orange

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Port Jervis, NY
  • NPI 1740227214

  Single Specialty

  Medicare reassignment NPD
• Access: Supports for Living Inc

  • Community/Behavioral Health Agency
  • Middletown, NY
  • NPI 1215122361
  NPD
• Access: Supports for Living Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Middletown, NY
  • NPI 1790326320
  NPD
• County of Orange

  dba The Valley View Certified Home Health Agency

  • Home Health Agency
  • Goshen, NY
  • NPI 1073016952
  NPD
• County of Orange

  dba Orange County Dept. of Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Newburgh, NY
  • NPI 1295889806
  NPD

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1649860818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 ROUTE 211EAST STE 24 #1110",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "10940",
            "telephone_number": "845-320-5942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1607 ROUTE 300 STE 115",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125501738",
            "telephone_number": "845-320-5942"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "141 Broadway",
            "address_purpose": "LOCATION",
            "city": "Newburgh",
            "state": "NY",
            "postal_code": "125506204",
            "country_code": "US",
            "telephone_number": "845-568-5260",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ANDREA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-21",
        "last_updated": "2023-06-30",
        "certification_date": "2023-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "095281-01",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "094835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "N/A",
            "identifier": "00",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel C Goodman, LCSW
• Allison Shannadean Gordon, RN
• Matthew Philip Gordon, M.D.
• Robert Gorman, P.T.
• Grace Family Pharmacy Inc. (Harinam Rx Pharmacy)
• Jonathan Alexander Graham, MHC-LP
• Brian P Grant, NPP
• Adria Gray, RN, CHPN, EOL DOULA
• Rebecca Gray
• Jenna Vanessa Graziano, MHC

• Clinical Social Worker in Newburgh, NY
• Providers in Newburgh, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.