Graham Pshchological Consulting and Restoration, Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20042049 Issued in IN

Legal business name

GRAHAM PSHCHOLOGICAL CONSULTING AND RESTORATION, INC

Practice address

9111 Broadway
Suite Q
Merrillville, IN 46410-8122

Phone

(773) 501-3557

Fax

(773) 275-1710

NPI assigned

Aug 27, 2007

Organization subpart

No

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

Authorized official

Name

Patricia Graham, PSYD HSPP

Title

Owner

Phone

(779) 275-1710

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Graham Psychological Consulting, Inc

  • Clinical Psychologist
  • Schererville, IN
  • NPI 1144548934

  O20071017000824

  Same enrollment

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

{
    "created_epoch": "1188172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189641600000",
    "number": "1932392537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5425 N PAULINA ST",
            "address_2": "UNIT 2 NORTH",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401139",
            "telephone_number": "773-501-3557",
            "fax_number": "773-275-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9111 BROADWAY",
            "address_2": "SUITE Q",
            "city": "MERRILLVILLE",
            "state": "IN",
            "postal_code": "464108122",
            "telephone_number": "773-501-3557",
            "fax_number": "773-275-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAHAM PSHCHOLOGICAL CONSULTING AND RESTORATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-27",
        "last_updated": "2007-09-13",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "779-275-1710",
        "authorized_official_credential": "PSYD HSPP"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20042049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIANA LICENSE NUMBER",
            "identifier": "20042049",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crisologo Rosel Gozo, C.R.N.A
• Grace Counseling and Associates, Inc.
• Darryl Stephen Graden, D.D.S.
• Sarah Graegin, PHARMD
• Kelley Grafton, MSN, RN
• Darnika Candice Graham, M.D.
• Paris Graham
• Grand Park Surgical Center, Inc
• Stephen Keith Grandfield, DPM
• Deborah Grandys, RD

• Clinical Psychologist in Merrillville, IN
• Providers in Merrillville, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.