Crystal Shamar Graham, LCAS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

8025 N Point Blvd Ste 283
Winston Salem, NC 27106-3860

Phone

(336) 842-3396

Fax

(336) 245-1804

NPI assigned

Nov 8, 2018

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

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Pathways to Self-Reliance

  • Community/Behavioral Health Agency
  • Winston Salem, NC
  • NPI 1235876988
  NPD Authorized official
• Brenda Marvet Butler

  dba Future Vision/Vision House

  • In Home Supportive Care Agency
  • Winston Salem, NC
  • NPI 1952599466

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731628800000",
    "number": "1952879827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8025 N POINT BLVD STE 283",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063860",
            "telephone_number": "336-920-1481",
            "fax_number": "336-245-1804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8025 N POINT BLVD STE 283",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271063860",
            "telephone_number": "336-842-3396",
            "fax_number": "336-245-1804"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "284 Executive Park Dr",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "280251831",
            "country_code": "US",
            "telephone_number": "704-939-1100",
            "fax_number": "704-939-1173",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "441 E Clemmonsville Rd",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "271075202",
            "country_code": "US",
            "telephone_number": "336-722-1505",
            "fax_number": "336-722-1505",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "CRYSTAL",
        "middle_name": "SHAMAR",
        "credential": "LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-08",
        "last_updated": "2024-11-15",
        "certification_date": "2024-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1235876988",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1952879827",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "25548833",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Graham Counseling & Associates, LLC
• Alea'Ah Graham
• Ayana Laura Graham, DPT
• Brianna Graham, RBT
• Charles Alan Graham, DC
• Gary Michael Graham, CRNA
• Justin Graham
• Sarah Bradford McCollum Graham, PA
• Valerie Wyke Granade, PT
• Courtney Haldeman Granadero, AGNP

• Addiction (Substance Use Disorder) Counselor in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Addiction (Substance Use Disorder) Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.