Jermaine Graves, LCPC, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PRC14258 Issued in DC

Practice address

9640 Marlboro Pike
Suite 202
Upper Marlboro, MD 20772

Phone

(240) 620-4421

NPI assigned

Dec 29, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jermaine Boston Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Peace of Mind Therapy, LLC

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  • NPI 1598247454
  NPD Authorized official

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

{
    "created_epoch": "1356739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1922344597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 RODIN COURT",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "20772",
            "telephone_number": "240-620-4421",
            "fax_number": "301-420-0793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9640 MARLBORO PIKE",
            "address_2": "SUITE 202",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "20772",
            "telephone_number": "240-620-4421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVES",
        "first_name": "JERMAINE",
        "name_prefix": "Mrs.",
        "credential": "LCPC, LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-29",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC4062",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "DC",
            "license": "PRC14258",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JERMAINE",
            "last_name": "BOSTON",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Professional Counselor in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.