Individual provider Active NPI

Jennifer D Graham, LMFT

  • Marriage & Family Therapist
  • Lauderhill, FL
National Provider Identifier
1750611679
Registry record updated Dec 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT2345 Issued in FL
Practice address
4200 NW 16TH St
#307
Lauderhill, FL 33313-5899
Phone
(954) 497-1420
Fax
(954) 497-3622
NPI assigned
Dec 29, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 29, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT2345 FL Primary

Addresses

Primary practice location

4200 NW 16TH St
#307
Lauderhill, FL 33313-5899

Mailing address

15706 E Waterside Cir
#206
Sunrise, FL 33326-2279
Phone (954) 701-4033

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
MT2345FLMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262044800000",
    "number": "1750611679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15706 E WATERSIDE CIR",
            "address_2": "#206",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333262279",
            "telephone_number": "954-701-4033",
            "fax_number": "954-497-3622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 NW 16TH ST",
            "address_2": "#307",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "333135899",
            "telephone_number": "954-497-1420",
            "fax_number": "954-497-3622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "JENNIFER",
        "middle_name": "D",
        "name_prefix": "Mrs.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-29",
        "last_updated": "2009-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT2345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lauderhill, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; 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.