Active NPI
Roxann Nole-Graham, M.S. NCC LPC
- Professional Counselor
- Scranton, PA
National Provider Identifier
1255619474
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PCOO5940
- Practice address
- 1141 Clay Ave
Scranton, PA 18510-1191 - Phone
- (570) 963-2079
- NPI assigned
- Jul 22, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PCOO5940 | PA | Primary |
Addresses
Primary practice location
1141 Clay Ave
Scranton, PA 18510-1191
Mailing address
902 Longview Ter
Clarks Summit, PA 18411-8923
Phone (570) 586-9258
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260209003143 | PA | Practitioner - Mental Health Counselor | 5698254753 | Practice locations: Clarks Summit, PA |
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
336 S State St
Clarks Summit, PA 18411-1549
Phone (570) 903-0399
902 Longview Ter
Waverly Township, PA 18411-8923
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PCOO5940 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311292800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311292800000",
"number": "1255619474",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "902 LONGVIEW TER",
"city": "CLARKS SUMMIT",
"state": "PA",
"postal_code": "184118923",
"telephone_number": "570-586-9258"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1141 CLAY AVE",
"city": "SCRANTON",
"state": "PA",
"postal_code": "185101191",
"telephone_number": "570-963-2079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NOLE-GRAHAM",
"first_name": "ROXANN",
"name_prefix": "Mrs.",
"credential": "M.S. NCC LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-22",
"last_updated": "2011-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PCOO5940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scranton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.