Individual provider Active NPI

La Risa Graham, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Fresh Meadows, NY
National Provider Identifier
1164769030
Registry record updated Sep 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
404814 Issued in NY
Practice address
6143 186TH St Ste 599
Fresh Meadows, NY 11365-2710
Phone
(551) 209-3506
Fax
(609) 363-1347
NPI assigned
Jan 11, 2013
Last updated
Sep 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 7, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 26NJ14844200 NJ
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 404814 NY Primary
Registered Nurse 163W00000X 794434 NY

Addresses

Primary practice location

6143 186TH St Ste 599
Fresh Meadows, NY 11365-2710

Mailing address

6143 Springfield Blvd Unit 640221
Bayside, NY 11364-3480
Phone (347) 753-8833

Other practice location 1

2 University Plz Ste 100
Hackensack, NJ 07601-6210
Phone (551) 209-3506

Other identifiers 1

IdentifierTypeStateIssuer
NONEOtherNONE

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
794434NYMDRegistered Nurse
26NJ14844200NJMDPsychiatric/Mental Health Nurse Practitioner
404814NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Hello Psychiatry LLC CurrentSince Feb 1, 2024 Accepting new patients
Hello NP in Psychiatry PLLC Psychiatric/Mental Health CurrentSince Aug 4, 2024 Accepting new patients

Locations

2 University Plz
Ste 100
Hackensack, NJ 07601
Phone (201) 744-7749

2 Federal Sq
Unit 28240
Newark, NJ 07101

6143 Springfield Blvd
Unit 640221
Bayside, NY 11364

6143 186th St
Ste 599
Fresh Meadows, NY 11365
Phone (347) 753-8833

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1357862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757203200000",
    "number": "1164769030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6143 SPRINGFIELD BLVD UNIT 640221",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113643480",
            "telephone_number": "347-753-8833"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6143 186TH ST STE 599",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113652710",
            "telephone_number": "551-209-3506",
            "fax_number": "609-363-1347"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 University Plz Ste 100",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076016210",
            "country_code": "US",
            "telephone_number": "551-209-3506",
            "fax_number": "609-363-1347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "LA RISA",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-11",
        "last_updated": "2025-09-07",
        "certification_date": "2025-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NJ",
            "license": "26NJ14844200",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "404814",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "794434",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2025; 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.