Active NPI
Denise Michele Lagrand, PSY.D.
- Clinical Psychologist
- Tahlequah, OK
National Provider Identifier
1174640700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 727
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 04-1P | AR | MD | Clinical Psychologist |
| 727 | OK | MD | Clinical Psychologist |
| 533 | AK | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Clinical Psychologist
- Tahlequah, OK
- NPI 1255459889
-
- Clinical Social Worker
- Tahlequah, OK
- NPI 1386665743
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.