Active NPI
Latrisha Tamara Graham
- Behavior Technician
- Portsmouth, VA
National Provider Identifier
1003682378
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Technician
- Practice address
- 100 Allen Rd
Portsmouth, VA 23702-2202 - Phone
- (757) 975-3698
- NPI assigned
- Nov 28, 2023
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Technician | 106S00000X | VA | Primary |
Addresses
Primary practice location
100 Allen Rd
Portsmouth, VA 23702-2202
Mailing address
350 Fairway Dr Ste 101
Deerfield Beach, FL 33441-1834
Phone (877) 418-2978
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1701129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1704844800000",
"number": "1003682378",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "350 FAIRWAY DR STE 101",
"city": "DEERFIELD BEACH",
"state": "FL",
"postal_code": "334411834",
"telephone_number": "877-418-2978",
"fax_number": "866-500-2186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 ALLEN RD",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237022202",
"telephone_number": "757-975-3698"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "LATRISHA",
"middle_name": "TAMARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-11-28",
"last_updated": "2024-01-10",
"certification_date": "2024-01-10",
"status": "A"
},
"taxonomies": [
{
"code": "106S00000X",
"taxonomy_group": "",
"desc": "Behavior Technician",
"state": "VA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portsmouth, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.