Individual provider Active NPI

Calvin Graham Sr., LMHC, CAP

  • Mental Health Counselor
  • Lauderhill, FL
National Provider Identifier
1992566616
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH21395 Issued in FL
Practice address
1801 NW 54TH Terrance #1
Lauderhill, FL 33313
Phone
(954) 683-2625
NPI assigned
Jan 19, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CAP0003362 FL
Mental Health Counselor 101YM0800X MH21395 FL Primary

Addresses

Primary practice location

1801 NW 54TH Terrance #1
Lauderhill, FL 33313

Mailing address

1801 NW 54TH Terrance #1
Lauderhill, FL 33313
Phone (954) 683-2625

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
MH21395FLMDMental Health Counselor
CAP0003362FLMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1705622400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1992566616",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 NW 54TH TERRANCE #1",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "33313",
            "telephone_number": "954-683-2625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 NW 54TH TERRANCE #1",
            "city": "LAUDERHILL",
            "state": "FL",
            "postal_code": "33313",
            "telephone_number": "954-683-2625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "CALVIN",
        "name_prefix": "Mr.",
        "name_suffix": "Sr.",
        "credential": "LMHC, CAP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-19",
        "last_updated": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "FL",
            "license": "CAP0003362",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH21395",
            "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 Jan 19, 2024; 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.