Individual ProviderEllen Anne GrahamCounselorBehavioral Health & Social Service ProvidersPractice Address1346 N Mulberry Ave, Upland, CA 91786-2739(909) 996-6217PECOS EnrollmentBased on the most recent information from CMS, provider Ellen Anne Graham does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1427155175Provider TypeIndividualFull NameGraham, Ellen AnneTitleMs.CredentialLCSWGenderFemaleSole ProprietorYesEnumeration Date9/17/2006Last Updated10/5/2021Contact InformationPractice LocationPractice Address1346 N Mulberry Ave, Upland, CA 91786-2739Phone(909) 996-6217FaxUnlisted FaxMailing LocationMailing Address1346 N Mulberry Ave, Upland, CA 91786-2739Phone(909) 996-6217FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseLCS13618California