Damon Graham Jr

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW005767 Issued in GA

Legal business name

DAMON GRAHAM JR

Doing business as

Magella Behavioral Health Consulting

Practice address

635 Myron Hart Rd
Coolidge, GA 31738-2143

Phone

(229) 224-0655

Fax

(229) 941-5865

NPI assigned

Jul 30, 2018

Last updated

Mar 9, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Damon Graham Jr., LCSW, MPA, MSNPI 1831545474

Title

Ceo

Phone

(229) 224-0655

Specialties & licenses 1

Addresses

Other names 1

• Magella Behavioral Health Consulting Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Damon Graham Jr., LCSW

  • Clinical Social Worker
  • Coolidge, GA
  • NPI 1831545474
  Authorized official Same address or phone

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

{
    "created_epoch": "1532908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552089600000",
    "number": "1780162008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 MYRON HART RD",
            "city": "COOLIDGE",
            "state": "GA",
            "postal_code": "317382143",
            "telephone_number": "229-224-0655",
            "fax_number": "229-941-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 MYRON HART RD",
            "city": "COOLIDGE",
            "state": "GA",
            "postal_code": "317382143",
            "telephone_number": "229-224-0655",
            "fax_number": "229-941-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAMON GRAHAM JR",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-30",
        "last_updated": "2019-03-09",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "DAMON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "229-224-0655",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LCSW, MPA, MS"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "CSW005767",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magella Behavioral Health Consulting",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joshua D Flounoy
• Patricia Ann Flounoy, OWNER
• Amanda Gandy, MSW
• Damon Graham Jr., LCSW
• Rebecca Marie Grave de Peralta, RN

• Clinical Social Worker in Coolidge, GA
• Providers in Coolidge, GA by specialty
• Clinical Social Worker in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2019; 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.