Individual provider Active NPI

Alan Grieco, PH.D.

  • Clinical Psychologist
  • Winter Park, FL
National Provider Identifier
1821147588
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PY0003386 Issued in FL
Practice address
2737 W Fairbanks Ave
Winter Park, FL 32789-3314
Phone
(407) 740-6838
Fax
(407) 740-0902
NPI assigned
Jan 10, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PY0003386 FL Primary

Addresses

Primary practice location

2737 W Fairbanks Ave
Winter Park, FL 32789-3314

Mailing address

2737 W Fairbanks Ave
Winter Park, FL 32789-3314
Phone (407) 740-6838

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
PY0003386FLMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Psychological Affiliates, Inc. Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821147588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2737 W FAIRBANKS AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327893314",
            "telephone_number": "407-740-6838",
            "fax_number": "407-740-0902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2737 W FAIRBANKS AVE",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327893314",
            "telephone_number": "407-740-6838",
            "fax_number": "407-740-0902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIECO",
        "first_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY0003386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.