Individual provider Active NPI

Stefanie Griffin, PHD

  • Clinical Neuropsychologist
  • Dover, NH
National Provider Identifier
1144374000
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
1026 Issued in NH
Practice address
1 Washington St Ste 4144
Dover, NH 03820-2236
Phone
(603) 740-6371
NPI assigned
Jan 22, 2007
Last updated
Nov 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 1026 NH Primary

Addresses

Primary practice location

1 Washington St Ste 4144
Dover, NH 03820-2236

Mailing address

16 Pinecrest LN
Durham, NH 03824-3112
Phone (603) 496-3399

Other identifiers 2

IdentifierTypeStateIssuer
3083123MedicaidNH
RE744101OtherNHMEDICARE PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20031223000473 NH Practitioner - Clinical Psychologist 0042118317 Practice locations: Dover, NH

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Nebraska College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

1 Washington St
Suite 443
Dover, NH 03820-3848
Phone (603) 740-6371

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1026NHMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Evaluation Specialists 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1144374000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 PINECREST LN",
            "city": "DURHAM",
            "state": "NH",
            "postal_code": "038243112",
            "telephone_number": "603-496-3399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WASHINGTON ST STE 4144",
            "city": "DOVER",
            "state": "NH",
            "postal_code": "038202236",
            "telephone_number": "603-740-6371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "STEFANIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "NH",
            "license": "1026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3083123",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "RE744101",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dover, NH

Sources for this page

Verify at the official NPI Registry.