Joan Mason Graham, LCSW
Individual provider Active NPI Mental Health Counselor · Centerport, NY
NPI 1215029665 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1215029665
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- PRO11593-1 (NY)
- Practice address
- 34 Marys LN
Centerport, NY 11721-1118 - Phone
- (631) 757-4670
- NPI assigned
- Sep 29, 2006
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PRO11593-1 | NY | MD | Mental Health Counselor |
| PRJO11593-1 | NY | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | PRO11593-1 | NY | Yes |
| Professional Counselor | 101YP2500X | PRJO11593-1 | NY |
Addresses
Primary practice location
34 Marys LN
Centerport, NY 11721-1118
Mailing address
34 Marys LN
Centerport, NY 11721-1118
Phone (631) 757-4670
Other providers in Centerport, NY
- Laura Ferrier
- Christi Fiore
- Cynthia Forstbauer
- Alyse Freda-Colon
- Lisa M Gaudioso
- David Green
- Christin Noel Griskie
- Christopher Joseph Grodski
- Victoria Gulino
- Soosan Happel
All providers in Centerport, NY · Mental Health Counselor in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.