Individual provider Active NPI

Brian Grady, PSY.D.

  • Clinical Psychologist
  • Brookline, MA
National Provider Identifier
1114107687
Registry record updated Mar 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
9244 Issued in MA
Practice address
126 Harvard St FL 3
Brookline, MA 02446-6426
Phone
(617) 232-3326
NPI assigned
Nov 13, 2007
Last updated
Mar 18, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 9244 MA Primary

Addresses

Primary practice location

126 Harvard St FL 3
Brookline, MA 02446-6426

Mailing address

126 Harvard St FL 3
Brookline, MA 02446-6426
Phone (617) 232-3326

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

NPI Registry JSON

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584489600000",
    "number": "1114107687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 HARVARD ST FL 3",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024466426",
            "telephone_number": "617-232-3326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 HARVARD ST FL 3",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024466426",
            "telephone_number": "617-232-3326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRADY",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-13",
        "last_updated": "2020-03-18",
        "certification_date": "2020-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "9244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; 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.