Active NPI
Alexis Diana Grant, PH.D.
- Clinical Psychologist
- Orange, CT
National Provider Identifier
1114850898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 028081-01
- Practice address
- 200 Edison Rd
Orange, CT 06477-3602 - Phone
- (973) 214-1951
- NPI assigned
- Jun 4, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 028081-01 | NY | Primary |
Addresses
Primary practice location
200 Edison Rd
Orange, CT 06477-3602
Mailing address
66 Vista Ter
New Haven, CT 06515-2402
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 028081-01 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1780531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1780531200000",
"number": "1114850898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 VISTA TER",
"city": "NEW HAVEN",
"state": "CT",
"postal_code": "065152402"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 EDISON RD",
"city": "ORANGE",
"state": "CT",
"postal_code": "064773602",
"telephone_number": "973-214-1951"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRANT",
"first_name": "ALEXIS",
"middle_name": "DIANA",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-06-04",
"last_updated": "2026-06-04",
"certification_date": "2026-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "028081-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orange, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.