Lauren Baillie Graves, PH.D.
Individual provider Active NPI Clinical Psychologist · Jackson, MS
NPI 1477898161 · NPPES record last updated Sep 2, 2020
Key facts
- NPI
- 1477898161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 1776 (AL)
- Practice address
- 1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116 - Phone
- (601) 364-7881
- NPI assigned
- Dec 6, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1776 | AL | Yes |
Addresses
Primary practice location
1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116
Mailing address
1500 E Woodrow Wilson Ave
Jackson, MS 39216-5116
Other providers in Jackson, MS
- Scotty W. Grantham
- Grassroots Therapy Solutions LLC
- Kim L. Gratz
- Mary K Gravel
- Glen Robert Graves
- Marilyn Davidson Graves
- Matthew L Graves
- Alan Gray
- Alvin Gray
- Carrie Horton Gray
All providers in Jackson, MS · Clinical Psychologist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.