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General NPI Number Information
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NPI Number | 1326092628
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Entity Type | Individual
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Provider Name | ANDREW J GRAFF LCSW
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Gender | Male
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Dates
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Enumeration Date | 05/20/2006
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Last Update Date | 04/25/2012
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Provider Practice Location Address
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Address Line | 12178 WILDFLOWER LN GUARDIAN ANGEL COUNSELING SERVICES LLC
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City | HUNTLEY
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State | IL
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Zip | 60142-7745
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Country | US
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Telephone | 779-552-6345
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1125 GUARDIAN ANGEL COUNSELING SERVICES LLC
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City | HUNTLEY
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State | IL
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Zip | 60142-1125
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Country | US
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Telephone | 312-404-1046
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149-008853
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License Number State | IL
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