Susan Lagrande, PHD
Individual provider Active NPI Clinical Psychologist · Anchorage, AK
NPI 1801925599 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1801925599
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- AK0321 (AK)
- Practice address
- 1407 W 31St Ave
Suite 602
Anchorage, AK 99503-3624 - Phone
- (907) 279-4406
- Fax
- (907) 272-4730
- NPI assigned
- Mar 6, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AK0321 | AK | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alliance Behavioral Medicine,LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | AK0321 | AK | Yes |
Addresses
Primary practice location
1407 W 31St Ave
Suite 602
Anchorage, AK 99503-3624
Mailing address
1407 W 31St Ave
Suite 602
Anchorage, AK 99503-3624
Phone (907) 279-4406
Other providers in Anchorage, AK
- Taylor Alan Ladner
- Alfredo Lafarga
- Vathsana Lafollette
- Danielle Francesca Lafon
- Filemon Lagon Jr.
- Sirpa Lahtinen-Gorman
- Julia Hallett Maury Lahue
- Tafaoga Laie
- Laima Assisted Living Home
- Derrick Lain
All providers in Anchorage, AK · Clinical Psychologist in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.