Bruce Graham, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

009710 Issued in CT

Practice address

98 York St
Yale Child Study Center Iicaps
New Haven, CT 06511

Phone

(203) 464-7721

Fax

(203) 785-6860

NPI assigned

May 29, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1527552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540512000000",
    "number": "1730670548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98 YORK ST",
            "address_2": "YALE CHILD STUDY CENTER IICAPS",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98 YORK ST",
            "address_2": "YALE CHILD STUDY CENTER IICAPS",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06511",
            "telephone_number": "203-464-7721",
            "fax_number": "203-785-6860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "BRUCE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-29",
        "last_updated": "2018-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CT",
            "license": "009710",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "009710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele Anne Goyette -Ewing, PHD
• Graham Mark Grabowski, DMD
• Grace Capozzelli Psychotherapy LLC
• Allyssa Baucom Graham, APRN
• Andrew Graham, M.D.
• Diojanni Graham
• Garrett Graham, PT
• Joy Susan Graham, MD
• Meghan Foley Graham, DMD
• Triniya Graham

• Clinical Social Worker in New Haven, CT
• Providers in New Haven, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2018; 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.