Michael Maxwell Grant, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1071 Issued in SC

Practice address

74 Lodge TRL
Pawleys Island, SC 29585-7935

Phone

(843) 655-5745

Fax

(843) 314-3784

NPI assigned

Nov 20, 2007

Sex

Male

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)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Strand Psychiatric Associates PA

  • Psychiatry Physician
  • Myrtle Beach, SC
  • NPI 1538229448
  NPD (past)

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

{
    "created_epoch": "1195516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492041600000",
    "number": "1336320126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 LODGE TRL",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295857935",
            "telephone_number": "843-655-5745",
            "fax_number": "843-314-3784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 LODGE TRL",
            "city": "PAWLEYS ISLAND",
            "state": "SC",
            "postal_code": "295857935",
            "telephone_number": "843-655-5745",
            "fax_number": "843-314-3784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "MICHAEL",
        "middle_name": "MAXWELL",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-20",
        "last_updated": "2017-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "SC",
            "license": "1071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rhonda Goodale
• Goodwill Transportation Services SC LLC
• Jenna T Gordon, FNP
• David Edwin Grabeman, D.D.S.
• Carla Stahl Graham, NP-C
• Patricia R Grant, M.D.
• Lynda Lou Grinnen, PTA
• Zifa Hackett
• Gretchen Hafner
• Scarlett Haley, P.T.

• Clinical Psychologist in Pawleys Island, SC
• Providers in Pawleys Island, SC by specialty
• Clinical Psychologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2017; 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.