Healthcare Provider Details

I. General information

NPI: 1609545086
Provider Name (Legal Business Name): BENJAMIN ANDREW GRAF MA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2021
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5407 ARROYO ST
COLORADO SPRINGS CO
80922-3633
US

IV. Provider business mailing address

5407 ARROYO ST
COLORADO SPRINGS CO
80922-3633
US

V. Phone/Fax

Practice location:
  • Phone: 720-608-7175
  • Fax:
Mailing address:
  • Phone: 303-551-2978
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPC.0022298
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: