Organization Active NPI

T Grant PHD

  • Clinical Psychologist
  • New Paltz, NY
National Provider Identifier
1215211719
Registry record updated Oct 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
011779 Issued in NY
Legal business name
T GRANT PHD
Practice address
257 Main St
New Paltz, NY 12561-1610
Phone
(845) 256-9528
Fax
(845) 256-9528
NPI assigned
Oct 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2011

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

Authorized official

Name
Dr. Thomas H Grant, PH.D.NPI 1437236247
Title
Clinical Psychologist
Phone
(845) 256-9528

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 011779 NY Primary

Addresses

Primary practice location

257 Main St
New Paltz, NY 12561-1610

Mailing address

257 Main St
New Paltz, NY 12561-1610
Phone (845) 256-9528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111206000298 NY Part B Supplier - Clinic/Group Practice 8224203005 Receives reassigned benefits from 1 practitioner
Practice locations: New Paltz, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1317600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317600000000",
    "number": "1215211719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "257 MAIN ST",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611610",
            "telephone_number": "845-256-9528",
            "fax_number": "845-256-9528"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "257 MAIN ST",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611610",
            "telephone_number": "845-256-9528",
            "fax_number": "845-256-9528"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "T GRANT PHD",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-03",
        "last_updated": "2011-10-03",
        "status": "A",
        "authorized_official_last_name": "GRANT",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "845-256-9528",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "011779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Paltz, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.