Tara Gravitt, LCSW, CAADC, CCM

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW020814 Issued in PA

Practice address

1601 Walnut St Ste 1017
Philadelphia, PA 19102-2906

Phone

(267) 308-4303

NPI assigned

Dec 7, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1607299200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607299200000",
    "number": "1699371419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9142",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191399142",
            "telephone_number": "267-308-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 WALNUT ST STE 1017",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191022906",
            "telephone_number": "267-308-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVITT",
        "first_name": "TARA",
        "credential": "LCSW, CAADC, CCM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-07",
        "last_updated": "2020-12-07",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "PA",
            "license": "8157",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Case Manager/Care Coordinator",
            "state": "PA",
            "license": "4237640",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW020814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Holly L Graves, MD
• Jillian M Graves, LCSW, MSW
• Joseph Graves, DPT
• Portia Maria Graves, M.A.
• Salina Dunbar Graves, M.D.
• Benjamin Leo Gray, MD
• Charles Gray, M.D.
• Christine Gray
• Christopher Gray, MS
• Cynthia Marie Gray, OTR/L

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.