Organization Active NPI

Graves Psychological Services

  • Clinical Psychologist
  • Thomasville, GA
National Provider Identifier
1083209712
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
GRAVES PSYCHOLOGICAL SERVICES
Practice address
319 N Stevens St
Thomasville, GA 31792-5464
Phone
(229) 221-3442
Fax
(855) 560-7664
NPI assigned
Mar 4, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Authorized official

Name
Montserrat Mitchell GravesNPI 1417261231
Title
Manager
Phone
(229) 221-3442

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X Primary

Addresses

Primary practice location

319 N Stevens St
Thomasville, GA 31792-5464

Mailing address

PO Box 231
Thomasville, GA 31799-0231
Phone (229) 221-3442

Other identifiers 1

IdentifierTypeStateIssuer
003110133CMedicaidGA

National Provider Directory

National Provider Directory

Locations

14538 US Highway 19 S
Thomasville, GA 31757
Phone (229) 233-6677

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1614816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617062400000",
    "number": "1083209712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 231",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317990231",
            "telephone_number": "229-221-3442",
            "fax_number": "855-560-7664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 N STEVENS ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925464",
            "telephone_number": "229-221-3442",
            "fax_number": "855-560-7664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAVES PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-04",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "MONTSERRAT",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "229-221-3442"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003110133C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; 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.