Tiffany Michelle Graham, MA, LCMHC-A, LCAS-A

Primary specialty

CounselorTaxonomy code 101Y00000X

License

16081 Issued in NC

Practice address

3545 Whitehall Park Dr Ste 300
Charlotte, NC 28273-4179

Phone

(980) 302-8850

Fax

(704) 316-8118

NPI assigned

Jul 12, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

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, 2018

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.

• Creative Opportunities for Personal Empowerment, LLC

  • Community/Behavioral Health Agency
  • Concord, NC
  • NPI 1558177659
  Medicare reassignment NPD Authorized official
• Building Empowerment LLC

  • Community/Behavioral Health Agency
  • Charlotte, NC
  • NPI 1346840345

  Addiction (Substance Use Disorder)

  NPD Authorized official

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660262400000",
    "number": "1548746605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3545 WHITEHALL PARK DR STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282734179",
            "telephone_number": "980-302-8850",
            "fax_number": "704-316-8118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1914 J N Pease Pl Ste 144",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282624504",
            "country_code": "US",
            "telephone_number": "919-478-0248",
            "fax_number": "704-559-3447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "TIFFANY",
        "middle_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "MA, LCMHC-A, LCAS-A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2022-08-12",
        "certification_date": "2022-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NC",
            "license": "LCAS-21224",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "A16081",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NC",
            "license": "16081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shekinah Graham, PHARMD
• Shenna Yvonne Graham, RDN, LMBT
• Stephanie Graham, L.P.C.
• Taqueena Z Graham, OTRL
• Taylor Michelle Graham
• Timothy Ashley Graham, LCAS-A
• Tony Graham, NP
• William C Graham, M.D.
• Zyana Graham
• Samantha Grambo, OTR/L-CLT

• Counselor in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 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.