Individual provider Active NPI

Shana Vandergriff, LCDC

  • Addiction (Substance Use Disorder) Counselor
  • Graham, TX
National Provider Identifier
1720957103
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
12494 Issued in TX
Practice address
1720 4TH St
Graham, TX 76450-2926
Phone
(940) 696-6182
NPI assigned
Nov 3, 2025
Last updated
Nov 3, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 12494 TX Primary

Addresses

Primary practice location

1720 4TH St
Graham, TX 76450-2926

Mailing address

500 W 4TH St
Breckenridge, TX 76424-2820
Phone (940) 329-9063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
12494TXMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1762128000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1720957103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 W 4TH ST",
            "city": "BRECKENRIDGE",
            "state": "TX",
            "postal_code": "764242820",
            "telephone_number": "940-329-9063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1720 4TH ST",
            "city": "GRAHAM",
            "state": "TX",
            "postal_code": "764502926",
            "telephone_number": "940-696-6182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERGRIFF",
        "first_name": "SHANA",
        "credential": "LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-03",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "12494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Graham, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2025; 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.