Active NPI
Patricia Marie Grayson, PH.D.
- School Psychologist
- Holbrook, NY
National Provider Identifier
1700155777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 012089-1
- Practice address
- 227 Springmeadow Dr Unit J
Holbrook, NY 11741-4132 - Phone
- (631) 472-2915
- NPI assigned
- Dec 21, 2011
- Last updated
- Sep 7, 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 |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 012089-1 | NY | Primary |
Addresses
Primary practice location
227 Springmeadow Dr Unit J
Holbrook, NY 11741-4132
Mailing address
227 Springmeadow Dr Unit J
Holbrook, NY 11741-4132
Phone (631) 472-2915
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 |
|---|---|---|---|
| 012089-1 | NY | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1324425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1694044800000",
"number": "1700155777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "227 SPRINGMEADOW DR UNIT J",
"city": "HOLBROOK",
"state": "NY",
"postal_code": "117414132",
"telephone_number": "631-472-2915"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "227 SPRINGMEADOW DR UNIT J",
"city": "HOLBROOK",
"state": "NY",
"postal_code": "117414132",
"telephone_number": "631-472-2915"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAYSON",
"first_name": "PATRICIA",
"middle_name": "MARIE",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-12-21",
"last_updated": "2023-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NY",
"license": "012089-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holbrook, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.