Active NPI
Olivia Elaine Grant, PSY.D.
- Clinical Psychologist
- Richmond, VA
National Provider Identifier
1508137282
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2737
- Practice address
- 2015 Staples Mill Rd
Richmond, VA 23230-3108 - Phone
- (804) 514-0296
- NPI assigned
- Jan 26, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2737 | KS | Primary |
Addresses
Primary practice location
2015 Staples Mill Rd
Richmond, VA 23230-3108
Mailing address
2015 Staples Mill Rd
Richmond, VA 23230-3108
Phone (804) 514-0296
Other practice location 1
2514 W North Shore Ave
Apt 1
Chicago, IL 60645-5049
Phone (773) 764-7610 ext. 233
Other practice location 2
4102 Westmorland Cir Apt 205
Fredericksburg, VA 22408-7876
Phone (773) 431-5633
Other names 1
- Olivia Ealine Culbreth III
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 |
|---|---|---|---|
| 2737 | KS | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1327536000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1580083200000",
"number": "1508137282",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2015 STAPLES MILL RD",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232303108",
"telephone_number": "804-514-0296"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2015 STAPLES MILL RD",
"city": "RICHMOND",
"state": "VA",
"postal_code": "232303108",
"telephone_number": "804-514-0296"
}
],
"practiceLocations": [
{
"address_1": "2514 W North Shore Ave",
"address_2": "Apt 1",
"address_purpose": "LOCATION",
"city": "Chicago",
"state": "IL",
"postal_code": "606455049",
"country_code": "US",
"telephone_number": "773-764-7610 x233",
"fax_number": "773-764-7619",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4102 Westmorland Cir Apt 205",
"address_purpose": "LOCATION",
"city": "Fredericksburg",
"state": "VA",
"postal_code": "224087876",
"country_code": "US",
"telephone_number": "773-431-5633",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GRANT",
"first_name": "OLIVIA",
"middle_name": "ELAINE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-01-26",
"last_updated": "2020-01-27",
"certification_date": "2020-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KS",
"license": "2737",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "OLIVIA",
"last_name": "CULBRETH",
"middle_name": "EALINE",
"suffix": "III",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Richmond, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.