AMY JOHANNA GRAHAM – Mental Health Counselor, NPI 1619641016

AMY JOHANNA GRAHAM is a healthcare provider. based in Chadron, Nebraska. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. 12717 (NE). The NPI Number for AMY JOHANNA GRAHAM is 1619641016

Main info

Female
Sole Proprietor
5 Years Of Experience
Accepts Medicare Assignment
Name
AMY JOHANNA GRAHAM
NPI
1619641016
Phone
(308) 856-9707
Address
910 BORDEAUX STREET
Enumeration Date
9 August 2021
Last Update Date
23 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3084301944
Graduation Year
2021 (5 years ago)
PAC ID
7618408006
Group Practice PAC ID
1951832849
Professional Enrollment ID
I20241009003611
Address ID
NE693372270CH709XXSTXX401
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:4State licenses:2Digital endpointsOther names

843 MENTAL HEALTH COUNSELOR in NE

Provider Addresses for AMY JOHANNA GRAHAM

  • 910 BORDEAUX STREET

    CHADRON, NE 693372617

    Phone: (308) 856-9707

    Type: Mailing

  • 910 BORDEAUX ST

    CHADRON, NE 693372617

    Phone: (308) 327-2026

    Type: Location

  • 1201 W 8th St

    Chadron, NE 693372940

    Phone: (308) 856-9707

    Type: Location

  • PO BOX 779

    RUSHVILLE, NE 693600779

    Phone: (308) 327-2026

    Type: Mailing

  • 309 W 3RD ST

    RUSHVILLE, NE 693604581

    Phone: (308) 327-2026

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-10-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241009003611IMental Health CounselorNETBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 69337)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1951832849View full group profile
NameSpecialtyState
Mental Health CounselorNE
Mental Health CounselorNE
Mental Health CounselorNE
Mental Health CounselorTX
Mental Health CounselorNE
Mental Health CounselorNE
Mental Health CounselorCA
Mental Health CounselorWI

Reviews

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Frequently asked questions

How is AMY JOHANNA GRAHAM identified in CMS data?
CMS-hosted NPPES data lists AMY JOHANNA GRAHAM with NPI 1619641016.
Is AMY JOHANNA GRAHAM still practicing?
AMY JOHANNA GRAHAM is currently listed as active in the public NPI registry.
What is AMY JOHANNA GRAHAM's primary classification?
Mental Health Counselor is the headline specialty for AMY JOHANNA GRAHAM here. Clinical services aligned with this taxonomy classification.
Where should I expect AMY JOHANNA GRAHAM on a map?
Expect Chadron, Nebraska as a primary anchor for AMY JOHANNA GRAHAM unless the record lists multiple sites.
Is the information about AMY JOHANNA GRAHAM up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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