Jeffrey Graham, MA, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

180013821 Issued in IL

Practice address

706 Oglesby Ave Ste 300
Normal, IL 61761-4616

Phone

(309) 212-3606

NPI assigned

Sep 22, 2020

Sex

Male

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

Not listed in the public Medicare enrollment file

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.

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

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.

• Elliott Counseling Services, LLC

  • Community/Behavioral Health Agency
  • Normal, IL
  • NPI 1396067559

  Professional

  NPD

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

{
    "created_epoch": "1600732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641254400000",
    "number": "1376159657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "706 OGLESBY AVE STE 300",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617614616",
            "telephone_number": "309-212-3606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "706 OGLESBY AVE STE 300",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617614616",
            "telephone_number": "309-212-3606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "JEFFREY",
        "credential": "MA, LCPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-22",
        "last_updated": "2022-01-04",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180013821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Miranda Leigh Gonzalez, APN, CNP
• Ajeet D Gordhan, M.D.
• Tammy Gordon, RN
• Panna U Goswami, MD
• Grace Medical Transport LLC
• Kathryn Grahs
• Molly Grant
• Lawrence Vincent Gratkins, MD
• Gravity Psychiatry & Wellness PLLC
• Amber Gray, RN

• Professional Counselor in Normal, IL
• Providers in Normal, IL by specialty
• Professional Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; 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.

Verify at the official NPI Registry.