Brooke Graham

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

A17396 Issued in NC

Practice address

136 Fairview Rd Ste 125
Mooresville, NC 28117-8547

Phone

(704) 667-7635

Fax

(980) 435-0398

NPI assigned

Oct 23, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

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

Specialty

Mental Health Counselor

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carolina Counseling and Consulting Services PLLC 8 clinicians

Practice addresses (Care Compare)

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.

• Carolina Counseling and Consulting Services, PLLC

  • Professional Counselor
  • Huntersville, NC
  • NPI 1639616782

  NC

  Medicare reassignment Care Compare group NPD
• Geode Health of North Carolina, PLLC

  • Psychiatry Physician
  • Durham, NC
  • NPI 1588433502
  NPD
• Kerry L. Musick, MD, PLLC

  • Psychiatry Physician
  • Mooresville, NC
  • NPI 1710402904
  NPD

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

{
    "created_epoch": "1540252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1396211892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 N JACKSON ST STE 202",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912064330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 FAIRVIEW RD STE 125",
            "city": "MOORESVILLE",
            "state": "NC",
            "postal_code": "281178547",
            "telephone_number": "704-667-7635",
            "fax_number": "980-435-0398"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "107 New Edition Court Carey",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "28202",
            "country_code": "US",
            "telephone_number": "818-241-6780",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "BROOKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-23",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "A17396",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Allen Goodson, MD
• Maje D. Goodwin, MD
• Rebecca Gordon, LN
• Grace Vision Care O.D., PLLC
• Jessica Jane Grace, OD
• Ashley Christina Grant, OTR/L
• Christopher Gray, DDS
• Erin Abbey Gray, FPN-C
• Evan Gray
• Robert C Gray Jr., DDS PA

• All providers in Mooresville, NC
• Mental Health Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 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.