Active NPI
Amanda J Graham, LPC
- Professional Counselor
- Durham, NC
National Provider Identifier
1023036738
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 3811
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 3272 | CO | MD | Clinical Psychologist |
| 3811 | NC | MD | Registered 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.