Kimberli Graham, LPCC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

0809 Issued in KY

Practice address

1311 N Dixie Hwy
Elizabethtown, KY 42701-2621

Phone

(270) 769-1304

Fax

(270) 234-8028

NPI assigned

Jun 5, 2006

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405468800000",
    "number": "1235178575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 CRANES ROOST CT",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427013650",
            "telephone_number": "270-765-2605",
            "fax_number": "270-766-1222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 N DIXIE HWY",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427012621",
            "telephone_number": "270-769-1304",
            "fax_number": "270-234-8028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "KIMBERLI",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-05",
        "last_updated": "2014-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "0809",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30605018",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11574917",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Karlee Grace, DO
• Amanda Jean Graham, MSBS, LCADC
• Arvella Jinnette Graham, LPCA
• Bethany Graham, LCSW
• Crystal S Graham
• Rachel W Graham
• Denise Michele Grant
• Marian Grant, LPCA
• David Alan Graves, D.M.D.
• Andrew S Gray, DPT

• Professional Counselor in Elizabethtown, KY
• Providers in Elizabethtown, KY by specialty
• Professional Counselor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; 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.