Individual provider Active NPI

Denise Michele Lagrand, PSY.D.

  • Clinical Psychologist
  • Tahlequah, OK
National Provider Identifier
1174640700
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
727 Issued in OK
Practice address
411 W Chickasaw St
Tahlequah, OK 74464-4301
Phone
(918) 931-9600
Fax
(918) 456-8773
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 727 OK Primary
Clinical Psychologist 103TC0700X 04-1P AR
Clinical Psychologist 103TC0700X 533 AK

Addresses

Primary practice location

411 W Chickasaw St
Tahlequah, OK 74464-4301

Mailing address

PO Box 1247
Tahlequah, OK 74465-1247
Phone (918) 931-9600

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

State licenses

LicenseStateTypeSpecialty
04-1PARMDClinical Psychologist
727OKMDClinical Psychologist
533AKMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Prodigy Foundation Past Accepting new patients
Denise Lagrand, Psy.D., LLC Clinical Past Accepting new patients

Organizations & group practices 2

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174640700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1247",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744651247",
            "telephone_number": "918-931-9600",
            "fax_number": "918-456-8773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 W CHICKASAW ST",
            "city": "TAHLEQUAH",
            "state": "OK",
            "postal_code": "744644301",
            "telephone_number": "918-931-9600",
            "fax_number": "918-456-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGRAND",
        "first_name": "DENISE",
        "middle_name": "MICHELE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OK",
            "license": "727",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AR",
            "license": "04-1P",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "AK",
            "license": "533",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tahlequah, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.