Active NPI
Dawn M Graham, PSYCHOLOGIST
- Psychologist
- Red Bank, NJ
National Provider Identifier
1497443113
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 35SI00708800
- Practice address
- 47B Rector PL
Red Bank, NJ 07701-1010 - Phone
- (612) 308-0818
- NPI assigned
- May 1, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 35SI00708800 | NJ | Primary |
Addresses
Primary practice location
47B Rector PL
Red Bank, NJ 07701-1010
Mailing address
47B Rector PL
Red Bank, NJ 07701-1010
Phone (612) 308-0818
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 35SI00708800 | NJ | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1682899200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682899200000",
"number": "1497443113",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "47B RECTOR PL",
"city": "RED BANK",
"state": "NJ",
"postal_code": "077011010",
"telephone_number": "612-308-0818"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "47B RECTOR PL",
"city": "RED BANK",
"state": "NJ",
"postal_code": "077011010",
"telephone_number": "612-308-0818"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "DAWN",
"middle_name": "M",
"credential": "PSYCHOLOGIST",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-01",
"last_updated": "2023-05-01",
"certification_date": "2023-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NJ",
"license": "35SI00708800",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Red Bank, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.