Daniel Seagrave, PSYD

Primary specialty

Forensic PsychologistTaxonomy code 103TF0200X

License

685 Issued in NM

Practice address

Martin Army, 6600 Van Aalst Blvd
BLDG 9250
Fort Moore, GA 31905

Phone

(505) 670-4484

NPI assigned

Nov 18, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1353196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722297600000",
    "number": "1366786121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "MARTIN ARMY, 6600 VAN AALST BLVD",
            "address_2": "BLDG 9250",
            "city": "FORT MOORE",
            "state": "GA",
            "postal_code": "31905",
            "telephone_number": "505-670-4484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MARTIN ARMY, 6600 VAN AALST BLVD",
            "address_2": "BLDG 9250",
            "city": "FORT MOORE",
            "state": "GA",
            "postal_code": "31905",
            "telephone_number": "505-670-4484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEAGRAVE",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-18",
        "last_updated": "2024-07-30",
        "certification_date": "2024-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NM",
            "license": "685",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "NM",
            "license": "685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anayeli Rodriguez, FNP
• Richard Trent Rogers, MD
• Wendy Kay Rowell
• Harjesus S Sandhu
• Christopher Scott Schloff, PA-C
• Alison M Setka, LMFT, ICADC
• Santosh Shanmuga, MD
• Afsheen Siddique, M.D.
• Gregory Sileo, DMD
• Jacqueline Renee Bell Simmons, DO

• Forensic Psychologist in Fort Moore, GA
• Providers in Fort Moore, GA by specialty
• Forensic Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; 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.