Angie J Graham, PSY.D.

Primary specialty

School PsychologistTaxonomy code 103TS0200X

Practice address

8766 E. Hwy 69
C/O Donna Thaxton Humboldt Unified School District/Sso
Prescott Valley, AZ 86314

Phone

(928) 759-4042

Fax

(928) 759-4030

NPI assigned

Aug 25, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1251158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251158400000",
    "number": "1245463264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8766 E. HWY 69",
            "address_2": "C/O DONNA THAXTON HUMBOLDT UNIFIED SCHOOL DISTRICT/SSO",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "86314",
            "telephone_number": "928-759-4042",
            "fax_number": "928-759-4030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8766 E. HWY 69",
            "address_2": "C/O DONNA THAXTON HUMBOLDT UNIFIED SCHOOL DISTRICT/SSO",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "86314",
            "telephone_number": "928-759-4042",
            "fax_number": "928-759-4030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAHAM",
        "first_name": "ANGIE",
        "middle_name": "J",
        "name_prefix": "Mrs.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-08-25",
        "last_updated": "2009-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• School Psychologist in Prescott Valley, AZ
• Providers in Prescott Valley, AZ by specialty
• School Psychologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2009; 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.