Individual provider Active NPI

Ginette Grube, PSYD, MP, RXP

  • Clinical Psychologist
  • Bellerose, NY
National Provider Identifier
1033550397
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
020108 Issued in NY
Practice address
74-03 Commonwealth Blvd,
Mid-Childhood Clinic, BLDG 55
Bellerose, NY 11426-1839
Phone
(718) 264-4500
NPI assigned
Jul 15, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Prescribing (Medical) PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TP0016X 325102 LA
Prescribing (Medical) Psychologist 103TP0016X 0000008 CO
Clinical Psychologist 103TC0700X 020108 NY Primary

Addresses

Primary practice location

74-03 Commonwealth Blvd,
Mid-Childhood Clinic, BLDG 55
Bellerose, NY 11426-1839

Mailing address

7403 Commonwealth Blvd
Bellerose, NY 11426-1839

Other practice location 1

627 Opelousas Ave
New Orleans, LA 70114-4343
Phone (631) 339-9291

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
0000008COMDPrescribing (Medical) Psychologist
325102LAMDPrescribing (Medical) Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Clinical Psychassociates LLP Psychologist Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756771200000",
    "number": "1033550397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7403 COMMONWEALTH BLVD",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114261839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74-03 COMMONWEALTH BLVD,",
            "address_2": "MID-CHILDHOOD CLINIC, BLDG 55",
            "city": "BELLEROSE",
            "state": "NY",
            "postal_code": "114261839",
            "telephone_number": "718-264-4500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "627 Opelousas Ave",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701144343",
            "country_code": "US",
            "telephone_number": "631-339-9291",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRUBE",
        "first_name": "GINETTE",
        "name_prefix": "Dr.",
        "credential": "PSYD, MP, RXP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-15",
        "last_updated": "2025-09-02",
        "certification_date": "2025-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "LA",
            "license": "325102",
            "primary": false
        },
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "CO",
            "license": "0000008",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "020108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellerose, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2025; 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.