Individual provider Active NPI

Jarrett Graham, MHS

  • Behavior Analyst
  • East Stroudsburg, PA
National Provider Identifier
1487087276
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
BH001545 Issued in PA
Practice address
175 E Brown St Ste 202
East Stroudsburg, PA 18301-3098
Phone
(570) 234-3989
NPI assigned
Aug 15, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Behavior Analyst 103K00000X BH001545 PA Primary

Addresses

Primary practice location

175 E Brown St Ste 202
East Stroudsburg, PA 18301-3098

Mailing address

1113 N 26TH St
Allentown, PA 18104-2901
Phone (570) 561-4105

Other practice location 1

1113 N 26th St
Allentown, PA 18104-2901
Phone (570) 561-4105

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

State licenses

LicenseStateTypeSpecialty
BH001545PAMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Live Learn & Play, Inc. Past Accepting new patients
Matrix Behavior Solutions, LLC Behavior Analyst PastSince Sep 12, 2021 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1376524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1487087276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1113 N 26TH ST",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181042901",
            "telephone_number": "570-561-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 E BROWN ST STE 202",
            "city": "EAST STROUDSBURG",
            "state": "PA",
            "postal_code": "183013098",
            "telephone_number": "570-234-3989"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1113 N 26th St",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181042901",
            "country_code": "US",
            "telephone_number": "570-561-4105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "JARRETT",
        "credential": "MHS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-15",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "PA",
            "license": "BH001545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Stroudsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2021; 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.