Daniel Ray Grisham

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

902 W Main St
West Frankfort, IL 62896-2210

Phone

(618) 937-6483

Fax

(618) 937-4709

NPI assigned

Oct 17, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617062400000",
    "number": "1891261871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 W MAIN ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628962210",
            "telephone_number": "618-937-6483",
            "fax_number": "618-937-4709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 W MAIN ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628962210",
            "telephone_number": "618-937-6483",
            "fax_number": "618-937-4709"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "402 E Plaza Dr Ste 4/5",
            "address_purpose": "LOCATION",
            "city": "Carterville",
            "state": "IL",
            "postal_code": "629182090",
            "country_code": "US",
            "telephone_number": "618-319-6060",
            "fax_number": "618-681-6824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRISHAM",
        "first_name": "DANIEL",
        "middle_name": "RAY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-17",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lakesha Graham, MA
• Nicole Melissa Grajewski, LCSW
• Donna Greer
• Joyce Ann Griffin, PH.D., LCPC
• Kevin Dale Griggs, PT
• Growspace MH
• Nancy M Gulley
• Akiya D Harris
• James Harris
• Paula K Harris, AU.D., CCC-A

• Behavior Analyst in West Frankfort, IL
• Providers in West Frankfort, IL by specialty
• Behavior Analyst in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 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.