Individual provider Active NPI

Erin Graham, LCPAT, ATR-BC

  • Professional Counselor
  • Frederick, MD
National Provider Identifier
1508242389
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
ATC122 Issued in MD
Practice address
263 W Patrick St
Frederick, MD 21701-6910
Phone
(301) 276-4997
NPI assigned
Aug 4, 2015
Last updated
Oct 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X ATC122 MD Primary

Addresses

Primary practice location

263 W Patrick St
Frederick, MD 21701-6910

Mailing address

10703 Lamoka LN
New Market, MD 21774-6891
Phone (410) 279-0380

Other practice location 1

15701 Crabbs Branch Way
Derwood, MD 20855-2634
Phone (301) 251-8965

Other practice location 2

13200 New Hampshire Ave
Silver Spring, MD 20904-3433
Phone (301) 960-1198 ext. 700

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
ATC122MDMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Re-Create: Therapy and Wellness CurrentSince Oct 30, 2022 Accepting new patients
Willow Oak Therapy Center, Inc. PastSince Jul 1, 2011 Accepting new patients
Jody Tabner Thayer LLC Past Accepting new patients

Locations

263 W Patrick St
Frederick, MD 21701
Phone (301) 276-4997

Organizations & group practices 3

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": "1438646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1508242389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10703 LAMOKA LN",
            "city": "NEW MARKET",
            "state": "MD",
            "postal_code": "217746891",
            "telephone_number": "410-279-0380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "263 W PATRICK ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217016910",
            "telephone_number": "301-276-4997"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15701 Crabbs Branch Way",
            "address_purpose": "LOCATION",
            "city": "Derwood",
            "state": "MD",
            "postal_code": "208552634",
            "country_code": "US",
            "telephone_number": "301-251-8965",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13200 New Hampshire Ave",
            "address_purpose": "LOCATION",
            "city": "Silver Spring",
            "state": "MD",
            "postal_code": "209043433",
            "country_code": "US",
            "telephone_number": "301-960-1198 x700",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ERIN",
        "credential": "LCPAT, ATR-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-04",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "ATC122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.