Active NPI
Kensie Brielle Graham, CASAC-T
- Addiction (Substance Use Disorder) Counselor
- Lyons, NY
National Provider Identifier
1992492714
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 37456
- Practice address
- 1519 Nye Rd
Lyons, NY 14489-9133 - Phone
- (315) 946-5722
- NPI assigned
- Apr 21, 2023
- Sex
- Female
- 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 | 37456 | NY | Primary |
Addresses
Primary practice location
1519 Nye Rd
Lyons, NY 14489-9133
Mailing address
1519 Nye Rd
Lyons, NY 14489-9133
Phone (315) 946-5722
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 |
|---|---|---|---|
| 37456 | NY | MD | Addiction (Substance Use Disorder) Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682035200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682985600000",
"number": "1992492714",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1519 NYE RD",
"city": "LYONS",
"state": "NY",
"postal_code": "144899133",
"telephone_number": "315-946-5722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1519 NYE RD",
"city": "LYONS",
"state": "NY",
"postal_code": "144899133",
"telephone_number": "315-946-5722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "KENSIE",
"middle_name": "BRIELLE",
"credential": "CASAC-T",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-04-21",
"last_updated": "2023-05-02",
"certification_date": "2023-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "37456",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lyons, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.