Active NPI
Heather Joie Graham, LCSW
- Clinical Social Worker
- Marietta, GA
National Provider Identifier
1740686757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW004407
- Practice address
- 707 Whitlock Ave SW Ste 28
Marietta, GA 30064-3000 - Phone
- (404) 643-6205
- NPI assigned
- Nov 18, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW004407 | GA | Primary |
Addresses
Primary practice location
707 Whitlock Ave SW Ste 28
Marietta, GA 30064-3000
Mailing address
2420 Elmhurst Blvd NW
Kennesaw, GA 30152-6008
Phone (404) 643-6205
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW004407 | GA | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Graham Counseling and Consultation LLC | Clinical | Current | Accepting new patients |
Locations
707 Whitlock Ave SW
Ste 28
Marietta, GA 30064
Phone (404) 643-6205
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1416268800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1578182400000",
"number": "1740686757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2420 ELMHURST BLVD NW",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301526008",
"telephone_number": "404-643-6205"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "707 WHITLOCK AVE SW STE 28",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300643000",
"telephone_number": "404-643-6205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "HEATHER",
"middle_name": "JOIE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-11-18",
"last_updated": "2020-01-05",
"certification_date": "2020-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW004407",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 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.