Individual provider Active NPI

Allison R Grodzki, PSY.D.

  • Clinical Psychologist
  • The Woodlands, TX
National Provider Identifier
1770969305
Registry record updated Sep 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
38916 Issued in TX
Practice address
26010 Oak Ridge Dr Ste 107
The Woodlands, TX 77380-1972
Phone
(281) 815-0899
NPI assigned
Aug 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 5014 CO
Clinical Psychologist 103TC0700X 38916 TX Primary

Addresses

Primary practice location

26010 Oak Ridge Dr Ste 107
The Woodlands, TX 77380-1972

Mailing address

3585 Falcon Way
Conroe, TX 77304-4880
Phone (701) 388-7490

Other names 1

  • Allie Deraney Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
5014COMDClinical Psychologist
38916TXMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Graciela F Reyes-McDonald CurrentSince Sep 5, 2021 Accepting new patients

Locations

26010 Oak Ridge Dr
Ste 107
The Woodlands, TX 77380
Phone (281) 296-5855

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1438732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1770969305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3585 FALCON WAY",
            "city": "CONROE",
            "state": "TX",
            "postal_code": "773044880",
            "telephone_number": "701-388-7490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26010 OAK RIDGE DR STE 107",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773801972",
            "telephone_number": "281-815-0899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRODZKI",
        "first_name": "ALLISON",
        "middle_name": "R",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-08-05",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "5014",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "38916",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLIE",
            "last_name": "DERANEY",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in The Woodlands, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; 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.