Provider Demographics
NPI:1962540286
Name:PHILIP S GRAFFUNDER MS MSW LCSW LLC
Entity type:Organization
Organization Name:PHILIP S GRAFFUNDER MS MSW LCSW LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:S
Authorized Official - Last Name:GRAFFUNDER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:404-295-4852
Mailing Address - Street 1:2371 NORWICH WAY
Mailing Address - Street 2:
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084
Mailing Address - Country:US
Mailing Address - Phone:404-295-4852
Mailing Address - Fax:
Practice Address - Street 1:2531 BRIARCLIFF RD
Practice Address - Street 2:STE 102
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30329
Practice Address - Country:US
Practice Address - Phone:404-295-4852
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0034181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty