Charles Graham, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC01338000 Issued in NJ

Practice address

12000 Lincoln Dr W
Suite 407 Pavilions at Greentree
Marlton, NJ 08053-3402

Phone

(856) 985-3404

Fax

(856) 985-7847

NPI assigned

Oct 20, 2006

Last updated

Dec 28, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198800000000",
    "number": "1770665242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 S ATLANTIC AVE",
            "city": "HADDONFIELD",
            "state": "NJ",
            "postal_code": "080333302",
            "telephone_number": "856-857-1656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12000 LINCOLN DR W",
            "address_2": "SUITE 407 PAVILIONS AT GREENTREE",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080533402",
            "telephone_number": "856-985-3404",
            "fax_number": "856-985-7847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC01338000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Gordon, MD
• Lauren D Gotay, M.D.
• Michele Lynn Gould-Grabarski, MA, CCC-SLP
• Stuart D Gould, M.D.
• Kathryn A Grady, D.D.S., M.S.
• Malvina Granovskaya, MS CCC-SLP
• Deanna Lynn Gray-Miceli, PHD., GNP-BC
• Greater New Jersey Creative Counseling
• Greater New Jersey Creative Counseling Inc
• Anthony Greco, CRNA

• Clinical Social Worker in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2007; 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.