Active NPI
Charlotte L Grillot, PHD
- Clinical Psychologist
- New York, NY
National Provider Identifier
1629829692
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 68-P127632-01
- Practice address
- 1177 Avenue of the Americas FL 5
New York, NY 10036-2714 - Phone
- (888) 242-2732
- NPI assigned
- Mar 28, 2024
- 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 | 68-P127632-01 | NY | Primary |
Addresses
Primary practice location
1177 Avenue of the Americas FL 5
New York, NY 10036-2714
Mailing address
1177 Avenue of the Americas FL 5
New York, NY 10036-2714
Phone (888) 242-2732
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 68-P127632-01 | NY | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711584000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716163200000",
"number": "1629829692",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1177 AVENUE OF THE AMERICAS FL 5",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100362714",
"telephone_number": "888-242-2732"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1177 AVENUE OF THE AMERICAS FL 5",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100362714",
"telephone_number": "888-242-2732"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRILLOT",
"first_name": "CHARLOTTE",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-28",
"last_updated": "2024-05-20",
"certification_date": "2024-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "68-P127632-01",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.