Individual provider Active NPI

Amanda J Graham, LPC

  • Professional Counselor
  • Durham, NC
National Provider Identifier
1023036738
Registry record updated Jan 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
3811 Issued in NC
Practice address
3622 Lyckan Pkwy Ste 4003
Durham, NC 27707-2566
Phone
(970) 410-1570
NPI assigned
Jul 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 3811 NC Primary
Professional Counselor 101YP2500X 3272 CO

Addresses

Primary practice location

3622 Lyckan Pkwy Ste 4003
Durham, NC 27707-2566

Mailing address

4203 Bahama Rd
Rougemont, NC 27572-8795
Phone (919) 810-6206

Other practice location 1

7961 Scenic Trl
Chapel Hill, NC 27516-8496
Phone (919) 410-1570

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

State licenses

LicenseStateTypeSpecialty
3272COMDClinical Psychologist
3811NCMDRegistered Respiratory Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548547200000",
    "number": "1023036738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4203 BAHAMA RD",
            "city": "ROUGEMONT",
            "state": "NC",
            "postal_code": "275728795",
            "telephone_number": "919-810-6206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3622 LYCKAN PKWY STE 4003",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277072566",
            "telephone_number": "970-410-1570"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7961 Scenic Trl",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275168496",
            "country_code": "US",
            "telephone_number": "919-410-1570",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "AMANDA",
        "middle_name": "J",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2019-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "3811",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "3272",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.