Active NPI
Melissa Grisdale, PHD
- Clinical Psychologist
- Katy, TX
National Provider Identifier
1467215038
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 38631
- Practice address
- 24546 Kingsland Blvd
Katy, TX 77494-3429 - Phone
- (832) 913-8747
- NPI assigned
- Feb 5, 2024
- Reactivated
- Oct 28, 2024
- Last updated
- Oct 28, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 71556 | TX | |
| Clinical Psychologist | 103TC0700X | 38631 | TX | Primary |
Addresses
Primary practice location
24546 Kingsland Blvd
Katy, TX 77494-3429
Mailing address
1319 Sweet Dumpling Dr
Richmond, TX 77406-2830
Phone (713) 202-1478
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 71556 | TX | MD | Professional Counselor |
| 38631 | TX | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730073600000",
"number": "1467215038",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1319 SWEET DUMPLING DR",
"city": "RICHMOND",
"state": "TX",
"postal_code": "774062830",
"telephone_number": "713-202-1478"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24546 KINGSLAND BLVD",
"city": "KATY",
"state": "TX",
"postal_code": "774943429",
"telephone_number": "832-913-8747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRISDALE",
"first_name": "MELISSA",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-05",
"last_updated": "2024-10-28",
"certification_date": "2024-02-05",
"deactivation_date": "2024-07-03",
"reactivation_date": "2024-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "TX",
"license": "71556",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "38631",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Katy, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.