Fatrenna Graham

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6401016270 Issued in MI

Practice address

24100 Southfield Rd Ste 204
Southfield, MI 48075-2851

Phone

(313) 663-0136

NPI assigned

Sep 18, 2020

Last updated

Sep 18, 2020By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Introspective Counseling, LLC

  • Mental Health Counselor
  • Southfield, MI
  • NPI 1831654326
  NPD (past)

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

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1649886243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15536",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482150536",
            "telephone_number": "313-663-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24100 SOUTHFIELD RD STE 204",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480752851",
            "telephone_number": "313-663-0136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "FATRENNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-18",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401016270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gracepoint Living, LLC
• Gracious Outreach Ministries
• Carlos Grady, MA, LLP
• Makensie Grady
• Sherri Lynn Graf, DO
• Goldyn Graham
• Jessica Graham
• Rebecca Rae Graham, CRNA
• Troi Graham
• Alison K. Granados, MD

• Mental Health Counselor in Southfield, MI
• Providers in Southfield, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.