Provider Demographics
NPI:1225104805
Name:GRAZIANO, FRANK RON (LICSW)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:RON
Last Name:GRAZIANO
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37E FLINTLOCK RD
Mailing Address - Street 2:
Mailing Address - City:LEDYARD
Mailing Address - State:CT
Mailing Address - Zip Code:06339-4948
Mailing Address - Country:US
Mailing Address - Phone:860-245-0501
Mailing Address - Fax:
Practice Address - Street 1:331 BROADWAY
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02909-1101
Practice Address - Country:US
Practice Address - Phone:401-575-8428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW015261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI26688-8OtherBLUE CROSS
RI62-70205OtherUNITED BEHAVIORAL HEALTH
RI1037670OtherBEACON HEALTH STRATEGIES