Kethlin Bach Graham

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

IMH21267 Issued in FL

Practice address

2900 N University Dr Ste 15
Coral Springs, FL 33065-5083

Phone

(561) 571-1557

Fax

(561) 634-3537

NPI assigned

Feb 28, 2022

Sex

Female

Sole proprietor

Yes

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

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

{
    "created_epoch": "1646006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646006400000",
    "number": "1700532850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 N UNIVERSITY DR STE 15",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330655083",
            "telephone_number": "561-571-1557",
            "fax_number": "561-634-3537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 N UNIVERSITY DR STE 15",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330655083",
            "telephone_number": "561-571-1557",
            "fax_number": "561-634-3537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "KETHLIN",
        "middle_name": "BACH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-02-28",
        "last_updated": "2022-02-28",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMH21267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Saul Grabosky, RPH
• Grace Cimino-Braunstein, L.M.H.C., P.a.
• Grace Counseling, Inc.
• Grace From Darkness, PLLC
• Cynthia Agatha Graham-Clark, COTA
• Samantha Grandson
• Sean Ryan Grange, PHARM D
• Sabrina Marie Sanchez Graves
• Green Health Consulting LLC
• Green Hearts Home Health Care

• Mental Health Counselor in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Mental Health Counselor in Florida

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