Active NPI
Grace Patrick
- Clinical Psychologist
- Las Vegas, NV
National Provider Identifier
1598693426
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PT101
- Practice address
- 4505 S Maryland Pkwy
Box 453033
Las Vegas, NV 89154-3033 - Phone
- (650) 274-6722
- NPI assigned
- May 11, 2026
- Sex
- Unspecified or another gender identity
- 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 | PT101 | NV | Primary |
Addresses
Primary practice location
4505 S Maryland Pkwy
Box 453033
Las Vegas, NV 89154-3033
Mailing address
4505 S Maryland Pkwy
Box 453033
Las Vegas, NV 89154-3033
Phone (650) 274-6722
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 |
|---|---|---|---|
| PT101 | NV | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1778457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1778457600000",
"number": "1598693426",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4505 S MARYLAND PKWY",
"address_2": "BOX 453033",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891543033",
"telephone_number": "650-274-6722"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4505 S MARYLAND PKWY",
"address_2": "BOX 453033",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891543033",
"telephone_number": "650-274-6722"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATRICK",
"first_name": "GRACE",
"sole_proprietor": "NO",
"sex": "X",
"enumeration_date": "2026-05-11",
"last_updated": "2026-05-11",
"certification_date": "2026-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NV",
"license": "PT101",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.