MEDICARE: TAMARA GRAHAM MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1164960522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA GRAHAM MSW

Provider Business Mailing Address
First Line	:	115 GRAND AVE STE 2
Second Line	:
City	:	DELTA
State	:	CO
Zip	:	81416-2000
Country	:	US
Telephone Number	:	970-874-0464
Fax Number	:

Provider Business Practice Location Address
First Line	:	515 28 3/4 RD
Second Line	:
City	:	GRAND JUNCTION
State	:	CO
Zip	:	81501-5016
Country	:	US
Telephone Number	:	970-263-4918
Fax Number	:	970-683-7278

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/06/2017
Last Update Date	:	01/16/2026

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