Basic Information
Provider Information
NPI: 1972517878
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: GRAF
FirstName: SHEILA
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: LSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4000 E CHARLESTON BLVD
Address2: B-230
City: LAS VEGAS
State: NV
PostalCode: 891046659
CountryCode: US
TelephoneNumber: 7029685000
FaxNumber: 7029685050
Practice Location
Address1: 4000 E CHARLESTON BLVD
Address2: B-230
City: LAS VEGAS
State: NV
PostalCode: 891046659
CountryCode: US
TelephoneNumber: 7029685000
FaxNumber: 7029685050
Other Information
ProviderEnumerationDate: 07/28/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
104100000X2682-SNVY Behavioral Health & Social Service ProvidersSocial Worker 

No ID Information.


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