Individual provider Active NPI

Melissa Robinson Graves, LMFT

  • Marriage & Family Therapist
  • Lilburn, GA
National Provider Identifier
1184759573
Registry record updated Apr 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFT001021 Issued in GA
Practice address
4656 Kellogg Dr SW
Lilburn, GA 30047-4408
Phone
(678) 982-2224
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFT001021 GA Primary

Addresses

Primary practice location

4656 Kellogg Dr SW
Lilburn, GA 30047-4408

Mailing address

4656 Kellogg Dr SW
Lilburn, GA 30047-4408
Phone (678) 982-2224

Other practice location 1

2080 Sugarloaf Pkwy
Suite 120
Lawrenceville, GA 30045-9401
Phone (770) 338-0800

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
MFT001021GAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Blue Resilience LLC Marriage & Family Therapist Current 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586044800000",
    "number": "1184759573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4656 KELLOGG DR SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300474408",
            "telephone_number": "678-982-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4656 KELLOGG DR SW",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300474408",
            "telephone_number": "678-982-2224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2080 Sugarloaf Pkwy",
            "address_2": "Suite 120",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300459401",
            "country_code": "US",
            "telephone_number": "770-338-0800",
            "fax_number": "770-338-2219",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBINSON GRAVES",
        "first_name": "MELISSA",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2020-04-05",
        "certification_date": "2020-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "GA",
            "license": "MFT001021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lilburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2020; 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.