Provider Demographics
NPI:1154724490
Name:RILEY-GRAHAM, MEGHAN (MSW)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:RILEY-GRAHAM
Suffix:
Gender:
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1351 NEWTOWN PIKE BLDG 5
Mailing Address - Street 2:TRANSITION CENTER
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-1282
Mailing Address - Country:US
Mailing Address - Phone:859-233-0444
Mailing Address - Fax:
Practice Address - Street 1:1351 NEWTOWN PIKE BLDG 5
Practice Address - Street 2:TRANSITION CENTER
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40511-1282
Practice Address - Country:US
Practice Address - Phone:859-233-0444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-01
Last Update Date:2025-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY7025104100000X
PACW0222941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1790731081Medicaid