Sally Graham, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

NY005618 Issued in NY

Practice address

24 E 12TH St
601A
New York, NY 10003-4403

Phone

(212) 807-0543

NPI assigned

Sep 19, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185148800000",
    "number": "1174518831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 E 14TH ST",
            "address_2": "1410",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100033122",
            "telephone_number": "212-803-5412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 E 12TH ST",
            "address_2": "601A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100034403",
            "telephone_number": "212-807-0543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "SALLY",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-19",
        "last_updated": "2007-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "NY005618",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "APA",
            "identifier": "AD001971",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01136429",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rahsaan Jamal Graham, OTR/L
• Rhea Graham, RPA-C
• Robert Graham, MD
• Robin Graham
• Roseanna Graham, D.D.S.
• Scott C Graham, MD
• Shaunette Graham
• Simone Graham
• Tonya Graham
• Virginia Graham, NP

• Psychologist in New York, NY
• Providers in New York, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2007; 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.