Individual
CYNTHIA GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSSW LCSW
Contact information
Practice address
6211 WATERFORD BLVD, EVANSVILLE, IN 47715-2869
(812) 465-6202
Mailing address
6211 WATERFORD BLVD, EVANSVILLE, IN 47715-2869
(812) 465-6202
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34002335A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000295773
ANTHEM
IN
05
—
100240880
—
IN
01
—
11490663
CAQH
IN
01
—
800006280
RAILROAD
IN
01
—
839090II
MEDICARE
IN
Enumeration date
08/11/2006
Last updated
10/27/2018
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