Individual provider Active NPI

Christy Lynn Graham, LCSW

  • Clinical Social Worker
  • Phoenix, AZ
National Provider Identifier
1972649671
Registry record updated May 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW2721 Issued in AZ
Practice address
16421 N Tatum Blvd Ste 130
Phoenix, AZ 85032-3444
Phone
(602) 339-5471
Fax
(602) 258-6140
NPI assigned
Jan 29, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2024

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 LCSW2721 AZ Primary

Addresses

Primary practice location

16421 N Tatum Blvd Ste 130
Phoenix, AZ 85032-3444

Mailing address

16421 N Tatum Blvd Ste 130
Phoenix, AZ 85032-3444
Phone (602) 339-5471

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW2721AZMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Terros, Inc. Past 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": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714608000000",
    "number": "1972649671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16421 N TATUM BLVD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323444",
            "telephone_number": "602-339-5471",
            "fax_number": "866-370-1447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16421 N TATUM BLVD STE 130",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323444",
            "telephone_number": "602-339-5471",
            "fax_number": "602-258-6140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "CHRISTY",
        "middle_name": "LYNN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2024-05-02",
        "certification_date": "2024-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AZ",
            "license": "LCSW2721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2024; 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.