Provider Demographics
NPI:1669487427
Name:SCOTT-GRAHAM, EMILY PAULETTE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:PAULETTE
Last Name:SCOTT-GRAHAM
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 PLANTATION BLVD SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30094-4119
Mailing Address - Country:US
Mailing Address - Phone:678-314-0241
Mailing Address - Fax:
Practice Address - Street 1:2470 WINDY HILL RD SE STE 300
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8621
Practice Address - Country:US
Practice Address - Phone:678-314-0241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2009-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0005491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical