Allie Grantham, MHR, LPC, CADC

Primary specialty

CounselorTaxonomy code 101Y00000X

License

6374 Issued in OK

Practice address

529 N Oak Ave
Tahlequah, OK 74464

Phone

(918) 444-2126

Fax

(918) 458-2300

NPI assigned

Mar 2, 2007

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 OK

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, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northeastern Oklahoma Community Health Centers, IncGroup PAC ID 3678482635, 38 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.

• Northeastern Oklahoma Community Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Hulbert, OK
  • NPI 1518070481

  OK

  Medicare reassignment Care Compare group NPD
• Northeastern Oklahoma Community Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Pryor, OK
  • NPI 1669101184
  NPD
• Northeastern Oklahoma Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Tahlequah, OK
  • NPI 1073164125
  NPD
• Muskogee County Council of Youth Service

  • Community/Behavioral Health Agency
  • Muskogee, OK
  • NPI 1215173133
  NPD (past)
• Muskogee County Council of Youth Services

  • Community/Behavioral Health Agency
  • Muskogee, OK
  • NPI 1639251457
  NPD (past)
• Northeastern Oklahoma Community Health Centers, Inc

  • Federally Qualified Health Center (FQHC)
  • Westville, OK
  • NPI 1821390402
  NPD (past)

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1447388178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31824 E 720 RD",
            "city": "WAGONER",
            "state": "OK",
            "postal_code": "744677374",
            "telephone_number": "918-485-9661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "529 N OAK AVE",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "74464",
            "telephone_number": "918-444-2126",
            "fax_number": "918-458-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANTHAM",
        "first_name": "ALLIE",
        "name_prefix": "Mrs.",
        "credential": "MHR, LPC, CADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OK",
            "license": "6374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Felicia Graff
• Wesley Gragg, ATC/L
• Stephanie Gran
• Grand Lake Mental Health Center, Inc.
• Grand View School
• Green Acres Residential Care
• Aelicia Fran Green
• Barbara Carlene Green, ARNP
• Charity Faith Green, LMSW-P
• Jaylen Z Green, MD

• Counselor in Tahlequah, OK
• Providers in Tahlequah, OK by specialty
• Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; 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.