Individual provider Active NPI

Danita A Graham, APSW

  • Clinical Social Worker
  • Madison, WI
National Provider Identifier
1770166506
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
130088-121 Issued in WI
Practice address
6417 Odana Rd
Suite 5
Madison, WI 53719
Phone
(608) 268-6530
Fax
(608) 709-1744
NPI assigned
Apr 29, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 130088-121 WI Primary

Addresses

Primary practice location

6417 Odana Rd
Suite 5
Madison, WI 53719

Mailing address

6417 Odana Rd
Suite 5
Madison, WI 53719
Phone (608) 268-6530

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

LicenseStateTypeSpecialty
130088-121WIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Anesis Center for Marriage and Family Therapy Clinical CurrentSince May 16, 2021 Accepting new patients

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": "1619654400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1770166506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6417 ODANA RD",
            "address_2": "SUITE 5",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53719",
            "telephone_number": "608-268-6530",
            "fax_number": "608-709-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6417 ODANA RD",
            "address_2": "SUITE 5",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "53719",
            "telephone_number": "608-268-6530",
            "fax_number": "608-709-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "DANITA",
        "middle_name": "A",
        "credential": "APSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-29",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "130088-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.