Individual provider Active NPI

Annette Graham, LSCSW

  • Clinical Social Worker
  • Wichita, KS
National Provider Identifier
1851198410
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LSCSW2133 Issued in KS
Practice address
545 N Woodlawn St
Wichita, KS 67208-3645
Phone
(316) 260-6889
NPI assigned
Feb 28, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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 LSCSW2133 KS Primary

Addresses

Primary practice location

545 N Woodlawn St
Wichita, KS 67208-3645

Mailing address

1324 S Todd CT
Wichita, KS 67207-4020
Phone (316) 519-4786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250407002631 KS Practitioner - Clinical Social Worker 4789923095 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
University of Kansas School of Med (KC/Wich/Sal), 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ict Therapyworks, LLCGroup PAC ID 6709176118, 9 clinicians

Practice addresses (Care Compare)

8100 E 22ND St N
BLDG 2100 Suite 1
Wichita, KS 67226-2350
Phone (316) 260-6889

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2133KSMDProfessional Counselor
LSCSW2133KSMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ict Therapy Works, LLC CurrentSince Mar 1, 2025 Accepting new patients

Locations

545 N Woodlawn St
Wichita, KS 67208
Phone (316) 260-6889

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": "1740700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1851198410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 S TODD CT",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672074020",
            "telephone_number": "316-519-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 N WOODLAWN ST",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672083645",
            "telephone_number": "316-260-6889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ANNETTE",
        "credential": "LSCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-28",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "LSCSW2133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.