Erica Danielle-Ellis Graham

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

572 Issued in WV

Practice address

262 Bluewell Ave
Bluefield, WV 24701-7580

Phone

(918) 273-8597

NPI assigned

Aug 18, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• GR&W, Inc

  • Clinical Neuropsychologist
  • Morgantown, WV
  • NPI 1407192024
  Medicare reassignment NPD
• Princeton Community Hospital Assn Inc.

  • Urology Physician
  • Princeton, WV
  • NPI 1093917643
  Medicare reassignment NPD
• Princeton Community Hospital Assn., Inc

  • Rural Health Clinic/Center
  • Bluefield, VA
  • NPI 1235446485
  NPD
• GR&W, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Morgantown, WV
  • NPI 1992665723
  NPD (past)

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

{
    "created_epoch": "1597708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679270400000",
    "number": "1255943759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 BLUEWELL AVE",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "247017580",
            "telephone_number": "918-273-8597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 BLUEWELL AVE",
            "city": "BLUEFIELD",
            "state": "WV",
            "postal_code": "247017580",
            "telephone_number": "918-273-8597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ERICA",
        "middle_name": "DANIELLE-ELLIS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-18",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "WV",
            "license": "572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ronald Goins
• Kelli Nicole Golden
• Goodykoontz Drug Stores Inc
• Jessica Jones Gotham, CRNA
• Alexis Graham
• Matthew Green, PHARM.D.
• Naomi Elizabeth Green
• Oretha Green
• Shelia Green
• Angela Greer

• Professional Counselor in Bluefield, WV
• Providers in Bluefield, WV by specialty
• Professional Counselor in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.