Ymg Psychological Services, PLLC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

YMG PSYCHOLOGICAL SERVICES, PLLC

Practice address

701 Devonshire Dr. BLD. C Suite 132
Champaign, IL 61820

Phone

(217) 278-0159

NPI assigned

Nov 22, 2022

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dynesha D Mason Grissom, PHD, LCP, MSCPNPI 1043789688

Title

Owner/Psychologist

Phone

(217) 278-0159

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dynesha Dione Mason-Grissom, PH.D.

  • Psychologist
  • Champaign, IL
  • NPI 1043789688
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1669075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669075200000",
    "number": "1629787239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 W GRAHAM DR",
            "city": "SAVOY",
            "state": "IL",
            "postal_code": "618749441",
            "telephone_number": "217-278-0159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 DEVONSHIRE DR. BLD. C SUITE 132",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "61820",
            "telephone_number": "217-278-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YMG PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-22",
        "last_updated": "2022-11-22",
        "certification_date": "2022-11-22",
        "status": "A",
        "authorized_official_last_name": "MASON GRISSOM",
        "authorized_official_first_name": "DYNESHA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "217-278-0159",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, LCP, MSCP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judith April Yasunaga, MD
• Nancy Jean Yeagle, OT/L
• Danielle Marie Yedvobnick, CCC-SLP
• Yes You Can Therapy Services, PC
• Justin Yeung
• Erika Ynga, DDS
• Haeyoon Yoon, OTRL
• James W Yoon, BA
• Young Chiropractic & Acupuncture, LTD.
• Emily Young, LSW

• Clinical Psychologist in Champaign, IL
• Providers in Champaign, IL by specialty
• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.