Active NPI
Vickie Roselee Graham, MSBS, MFT-US
- Marriage & Family Therapist
- Lawton, OK
National Provider Identifier
1033492020
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 1719 SW 11TH St
Lawton, OK 73501-7305 - Phone
- (580) 581-1818
- Fax
- (580) 581-1819
- NPI assigned
- Sep 26, 2011
- 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 |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | |||
| Marriage & Family Therapist | 106H00000X | OK | Primary |
Addresses
Primary practice location
1719 SW 11TH St
Lawton, OK 73501-7305
Mailing address
1719 SW 11TH St
Lawton, OK 73501-7305
Phone (580) 581-1818
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200392130A | Medicaid | OK |
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": "1316995200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338940800000",
"number": "1033492020",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1719 SW 11TH ST",
"city": "LAWTON",
"state": "OK",
"postal_code": "735017305",
"telephone_number": "580-581-1818",
"fax_number": "580-581-1819"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1719 SW 11TH ST",
"city": "LAWTON",
"state": "OK",
"postal_code": "735017305",
"telephone_number": "580-581-1818",
"fax_number": "580-581-1819"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "VICKIE",
"middle_name": "ROSELEE",
"name_prefix": "Mrs.",
"credential": "MSBS, MFT-US",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-26",
"last_updated": "2012-06-06",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": false
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OK",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200392130A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawton, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.