Individual provider Active NPI

Lenzy O'Dell Graham, M.A. LPC-A

  • Mental Health Counselor
  • Whiteville, NC
National Provider Identifier
1275991150
Registry record updated Feb 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
A10941 Issued in NC
Practice address
603 S Madison St
Whiteville, NC 28472-4129
Phone
(910) 640-3538
NPI assigned
Feb 5, 2016
Last updated
Feb 5, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X A10941 NC Primary

Addresses

Primary practice location

603 S Madison St
Whiteville, NC 28472-4129

Mailing address

603 S Madison St
Whiteville, NC 28472-4129
Phone (910) 640-3538

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
A10941NCMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Bridge of Hope Wellness LLC Mental Health Current Accepting new patients
Carter Clinic, PA Past Accepting new patients
Carter Clinic PA Past Accepting new patients
Carter Clinic, P.a. PastSince Aug 25, 2019 Accepting new patients
Carter Clinic PA PastSince Mar 4, 2021 Accepting new patients
Carter Clinic, P.a. PastSince Mar 4, 2021 Accepting new patients

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1454630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454630400000",
    "number": "1275991150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 S MADISON ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284724129",
            "telephone_number": "910-640-3538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "603 S MADISON ST",
            "city": "WHITEVILLE",
            "state": "NC",
            "postal_code": "284724129",
            "telephone_number": "910-640-3538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "LENZY",
        "middle_name": "O'DELL",
        "credential": "M.A. LPC-A",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-05",
        "last_updated": "2016-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A10941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whiteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2016; 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.