Provider Demographics
NPI:1962466060
Name:GRAFF, CAROL BLISS (LCSW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:BLISS
Last Name:GRAFF
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 1:11 MINISTERIAL RD
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:ME
Mailing Address - Zip Code:04856-5515
Mailing Address - Country:US
Mailing Address - Phone:207-593-6075
Mailing Address - Fax:
Practice Address - Street 1:69 ELM ST STE 103
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:ME
Practice Address - Zip Code:04843-1954
Practice Address - Country:US
Practice Address - Phone:207-593-6075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-14
Last Update Date:2020-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC43051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical