Provider Demographics
NPI:1548534043
Name:CHAD A GRAFF, PH.D., LLC
Entity type:Organization
Organization Name:CHAD A GRAFF, PH.D., LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:A
Authorized Official - Last Name:GRAFF
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:435-414-1633
Mailing Address - Street 1:230 N 1680 E BLDG F
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-2579
Mailing Address - Country:US
Mailing Address - Phone:435-414-1633
Mailing Address - Fax:
Practice Address - Street 1:230 N 1680 E BLDG F
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-2579
Practice Address - Country:US
Practice Address - Phone:435-414-1633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-01
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT79211516004101YP2500X
UT79211513902106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty