Individual provider Active NPI

Gordon M. Grant, PSY.D

  • Clinical Psychologist
  • Amherst, MA
National Provider Identifier
1316047244
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
7575 Issued in MA
Practice address
120 Pulpit Hill Rd Unit 45
Amherst, MA 01002-4013
Phone
(413) 230-4310
Fax
(413) 230-4310
NPI assigned
Sep 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 7575 PR MA
Clinical Psychologist 103TC0700X 7575 MA Primary

Addresses

Primary practice location

120 Pulpit Hill Rd Unit 45
Amherst, MA 01002-4013

Mailing address

120 Pulpit Hill Rd Unit 45
Amherst, MA 01002-4013
Phone (413) 230-4310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150112002083 MA Practitioner - Clinical Psychologist 8729132642 Practice locations: Northampton, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

206 State St
Northampton, MA 01060-2265
Phone (413) 230-4310

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7575 PRMAMDClinical Psychologist
7575MAMDOccupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1316047244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 PULPIT HILL RD UNIT 45",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010024013",
            "telephone_number": "413-230-4310",
            "fax_number": "413-527-3186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 PULPIT HILL RD UNIT 45",
            "city": "AMHERST",
            "state": "MA",
            "postal_code": "010024013",
            "telephone_number": "413-230-4310",
            "fax_number": "413-230-4310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "GORDON",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PSY.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7575 PR",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "7575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amherst, MA

Sources for this page

Verify at the official NPI Registry.