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General NPI Number Information
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NPI Number | 1649906900
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Entity Type | Individual
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Provider Name | CAROLINE SHANNON GRAZIANO MSW, LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/28/2022
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 401 HIGHLAND AVE
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City | SOMERVILLE
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State | MA
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Zip | 02144-2516
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Country | US
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Telephone | 339-368-7696
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Fax |
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Provider Business Mailing Address
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Address Line | 4600 MONTGOMERY RD STE 400
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City | CINCINNATI
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State | OH
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Zip | 45212-2600
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Country | US
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Telephone | 513-873-1269
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | LCSW225497
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License Number State | MA
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