Individual provider Active NPI

Lee Combrinck-Graham, M.D,

  • Child & Adolescent Psychiatry Physician
  • Stamford, CT
National Provider Identifier
1205920667
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
033302 Issued in CT
Practice address
1515 Summer Street Unit 605
Stamford, CT 06905
Phone
(203) 323-6333
Fax
(815) 642-8192
NPI assigned
Oct 2, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 033302 CT
Child & Adolescent Psychiatry Physician 2084P0804X 033302 CT Primary

Addresses

Primary practice location

1515 Summer Street Unit 605
Stamford, CT 06905

Mailing address

1515 Summer St Unit 605
Stamford, CT 06905-5154
Phone (203) 323-6333

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
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
033302CTMDPsychiatry Physician

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1205920667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 SUMMER ST UNIT 605",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069055154",
            "telephone_number": "203-323-6333",
            "fax_number": "815-642-8192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 SUMMER STREET UNIT 605",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "06905",
            "telephone_number": "203-323-6333",
            "fax_number": "815-642-8192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMBRINCK-GRAHAM",
        "first_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "M.D,",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "033302",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CT",
            "license": "033302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; 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.