Individual provider Active NPI

Amy Johanna Graham

  • Mental Health Counselor
  • Chadron, NE
National Provider Identifier
1619641016
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
3637 Issued in NE
Practice address
910 Bordeaux St
Chadron, NE 69337-2617
Phone
(308) 327-2026
NPI assigned
Aug 9, 2021
Last updated
Jan 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 12717 NE
Mental Health Counselor 101YM0800X 3637 NE Primary

Addresses

Primary practice location

910 Bordeaux St
Chadron, NE 69337-2617

Mailing address

910 Bordeaux Street
Chadron, NE 69337-2617
Phone (308) 856-9707

Other practice location 1

1201 W 8th St
Chadron, NE 69337-2940
Phone (308) 856-9707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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

Enrollment IDStateProvider typePAC IDDetails
I20241009003611 NE Practitioner - Mental Health Counselor 7618408006 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Inspirit Counseling PCGroup PAC ID 1951832849, 8 clinicians

Practice addresses (Care Compare)

630 W 2ND St
Chadron, NE 69337-2205
Phone (308) 856-9707

709 W 4TH St
Suite 2
Chadron, NE 69337-2270
Phone (308) 430-1944

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12717NEMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Graham Counseling LLC Mental Health CurrentSince Sep 25, 2022 Accepting new patients
Inspirit Counseling PC CurrentSince Oct 2, 2024 Accepting new patients
Gordon Memorial Hospital PastSince Aug 1, 2021 Accepting new patients
Western Nebraska Behavioral Health PastSince Aug 1, 2021 Accepting new patients

Locations

1201 W 8th St
Chadron, NE 69337
Phone (308) 856-9707

709 W 4th St
Chadron, NE 69337
Phone (308) 430-1944

709 W 4th St
#2
Chadron, NE 69337
Phone (308) 430-1944

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/gordon-7f82821b

Organizations & group practices 4

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": "1628467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1619641016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 BORDEAUX STREET",
            "city": "CHADRON",
            "state": "NE",
            "postal_code": "693372617",
            "telephone_number": "308-856-9707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 BORDEAUX ST",
            "city": "CHADRON",
            "state": "NE",
            "postal_code": "693372617",
            "telephone_number": "308-327-2026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 W 8th St",
            "address_purpose": "LOCATION",
            "city": "Chadron",
            "state": "NE",
            "postal_code": "693372940",
            "country_code": "US",
            "telephone_number": "308-856-9707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "AMY",
        "middle_name": "JOHANNA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-09",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "12717",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "3637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chadron, NE

Sources for this page

Verify at the official NPI Registry.