Provider Demographics
NPI:1306710728
Name:GRAGG, PATIENCE HAVEN (LCSWA)
Entity type:Individual
Prefix:
First Name:PATIENCE
Middle Name:HAVEN
Last Name:GRAGG
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3624
Mailing Address - Street 2:
Mailing Address - City:MORGANTON
Mailing Address - State:NC
Mailing Address - Zip Code:28680-3624
Mailing Address - Country:US
Mailing Address - Phone:828-544-8321
Mailing Address - Fax:828-572-2523
Practice Address - Street 1:144 TREMONT PARK DR SE
Practice Address - Street 2:
Practice Address - City:LENOIR
Practice Address - State:NC
Practice Address - Zip Code:28645-4642
Practice Address - Country:US
Practice Address - Phone:828-544-8321
Practice Address - Fax:828-572-2523
Is Sole Proprietor?:No
Enumeration Date:2025-09-30
Last Update Date:2025-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0212851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical