Individual ProviderWayne GravesSocial WorkerBehavioral Health & Social Service ProvidersPractice Address2020 E Grand Ave, Laramie, WY 82070-4383(307) 761-3489PECOS EnrollmentBased on the most recent information from CMS, provider Wayne Graves is legally eligible to order and refer claims for Part B and DME services only.Part BMedicare Part BEnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:54 AM.Profile DetailsProvider ID1730235300Provider TypeIndividualFull NameGraves, WayneCredentialLCSWGenderMaleSole ProprietorYesEnumeration Date1/26/2007Last Updated12/15/2023Contact InformationPractice LocationPractice Address2020 E Grand Ave, Laramie, WY 82070-4383Phone(307) 761-3489FaxUnlisted FaxMailing LocationMailing Address4127 Foothills St, Laramie, WY 82070-5606Phone(307) 761-3489FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicenseLCSW-505Wyoming