Active NPI
Matthew Graham, CADC
- Addiction (Substance Use Disorder) Counselor
- Minburn, IA
National Provider Identifier
1922897347
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 20081
- Practice address
- 19563 Lexington Rd
Minburn, IA 50167-8149 - Phone
- (845) 283-8919
- Fax
- (845) 283-8919
- NPI assigned
- May 2, 2025
- Last updated
- May 2, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 20081 | IA | Primary |
Addresses
Primary practice location
19563 Lexington Rd
Minburn, IA 50167-8149
Mailing address
211 E Court Ave
Des Moines, IA 50309-2012
Phone (845) 283-8919
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
| License | State | Type | Specialty |
|---|---|---|---|
| 20081 | IA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1746144000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1746144000000",
"number": "1922897347",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "211 E COURT AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503092012",
"telephone_number": "845-283-8919",
"fax_number": "845-283-8919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19563 LEXINGTON RD",
"city": "MINBURN",
"state": "IA",
"postal_code": "501678149",
"telephone_number": "845-283-8919",
"fax_number": "845-283-8919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "MATTHEW",
"credential": "CADC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-05-02",
"last_updated": "2025-05-02",
"certification_date": "2025-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "IA",
"license": "20081",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minburn, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 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.