Ellen D. Graham, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

2947 Issued in TN

Practice address

1832 Memorial Dr
Clarksville, TN 37043-6311

Phone

(931) 645-3552

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 1

Addresses

Other names 1

• Dr. Teresa Ellen Graham Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370995200000",
    "number": "1629106331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2212 GLORY DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370431812",
            "telephone_number": "931-378-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1832 MEMORIAL DR",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370436311",
            "telephone_number": "931-645-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ELLEN",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-02",
        "last_updated": "2013-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TN",
            "license": "2947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "GRAHAM",
            "middle_name": "ELLEN",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Marian Theresa Graham
• Sandra G Graham, LPC
• Tyler Graham
• Katie Rose Grandowicz, OTD, OTR/L
• Ginger A Graves, PHARMD

• All providers in Clarksville, TN
• Psychologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2013; 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.