Provider Demographics
NPI:1679874937
Name:GRAZIANO, MEGAN (LMSW)
Entity type:Individual
Prefix:MRS
First Name:MEGAN
Middle Name:
Last Name:GRAZIANO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:ILION
Mailing Address - State:NY
Mailing Address - Zip Code:13357-1722
Mailing Address - Country:US
Mailing Address - Phone:315-895-0785
Mailing Address - Fax:
Practice Address - Street 1:85 1ST AVE
Practice Address - Street 2:
Practice Address - City:ILION
Practice Address - State:NY
Practice Address - Zip Code:13357-1722
Practice Address - Country:US
Practice Address - Phone:315-895-0785
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0661581041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool