Teresa Mary Graham, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

5835 Issued in MN

Practice address

701 Decatur Ave N
Golden Valley, MN 55427-4363

Phone

(763) 746-2400

Fax

(763) 746-2401

NPI assigned

Aug 6, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249516800000",
    "number": "1962633040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4837 EWING AVE S",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554101749",
            "telephone_number": "612-927-9841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DECATUR AVE N",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554274363",
            "telephone_number": "763-746-2400",
            "fax_number": "763-746-2401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "TERESA",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-06",
        "last_updated": "2009-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "5835",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "MN",
            "license": "259010",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Goodstead LLC
• Celeste Kay Gorman
• Megan J. Gosse, DPT
• Samantha Jo Graf, DNP, FNP-BC
• Sasha Graham
• Todd Fleming Grant, MD
• Maryjo Graske, LMFT
• Lauren E Graveline, COTA/L
• Gregory Allen Gray, LMFT
• Great Lake Care LLC

• Clinical Social Worker in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2009; 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.