Jacquelyn J. Graven, PSYD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

129389 Issued in KY

Practice address

8007 Lyndon Circle Way
Ste 101
Louisville, KY 40222

Phone

(502) 690-8024

Fax

(502) 690-8090

NPI assigned

Jul 18, 2006

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

Enrolled in KY

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

Specialty

Clinical Psychologist

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Graven and Associates PLLCGroup PAC ID 2567779713, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Graven and Associates, PLLC

  • Clinical Neuropsychologist
  • Louisville, KY
  • NPI 1568846707
  Medicare reassignment Care Compare group Authorized official
• Larry M. Raskin, PH.D., P.S.C.

  • Psychologist
  • Louisville, KY
  • NPI 1952389389
  NPD (past)

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1396763249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8007 LYNDON CIRCLE WAY",
            "address_2": "STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40222",
            "telephone_number": "502-690-8024",
            "fax_number": "502-690-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8007 LYNDON CIRCLE WAY",
            "address_2": "STE 101",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "40222",
            "telephone_number": "502-690-8024",
            "fax_number": "502-690-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAVEN",
        "first_name": "JACQUELYN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "KY",
            "license": "129389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Lane Gratz, CPSS
• Gabriela Grau Apa, APRN
• Roberto Jose Grau Varela, APRN
• Nina Grau
• Graven and Associates, PLLC
• Robert Alan Graven, MSSW
• William Lee Graven Jr., DMD
• Alecia Ellen Graves, MD
• James Anderson Graves, LCSW
• James Benedict Graves Jr., PHARM.D.

• Clinical Neuropsychologist in Louisville, KY
• Providers in Louisville, KY by specialty
• Clinical Neuropsychologist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.