Active NPI
Justice Ashanti Graham, LAC
- Mental Health Counselor
- Phoenix, AZ
National Provider Identifier
1184421588
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 23003
- Practice address
- 112 N Central Ave Ste M43
Phoenix, AZ 85004-2309 - Phone
- (888) 500-2067
- Fax
- (617) 649-8520
- NPI assigned
- Feb 25, 2025
- Last updated
- Feb 25, 2025
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 23003 | AZ | Primary |
Addresses
Primary practice location
112 N Central Ave Ste M43
Phoenix, AZ 85004-2309
Mailing address
700 Massachusetts Ave FL 3
Cambridge, MA 02139-3345
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 |
|---|---|---|---|
| 23003 | AZ | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cartwheel Health Services PC | Mental Health | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Child & Adolescent Psychiatry Physician
- Cambridge, MA
- NPI 1912633975
Mental Health
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1740441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1740441600000",
"number": "1184421588",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 MASSACHUSETTS AVE FL 3",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021393345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "112 N CENTRAL AVE STE M43",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850042309",
"telephone_number": "888-500-2067",
"fax_number": "617-649-8520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "JUSTICE",
"middle_name": "ASHANTI",
"credential": "LAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-02-25",
"last_updated": "2025-02-25",
"certification_date": "2025-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "AZ",
"license": "23003",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.