DR. JACQUELYN J. GRAVEN (NPI# 1396763249) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396763249 |
| Entity Type | Individual |
| Full Name | DR. JACQUELYN J. GRAVEN |
| Credential | PSYD |
| Practice Address |
421 Benjamin Lane Ste 202 Louisville KY 40222 |
| Practice Telephone | 5026908024 |
| Practice Fax Number | 5026908090 |
| Mailing Telephone | 5026908024 |
| Mailing Fax Number | 5026908090 |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2016-06-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 129389 | KY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS KY | 000000962478 | 01 |
| Street Address |
421 BENJAMIN LANE STE 202 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40222 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740881507 | Lucas Counseling and Consulting | Counselor | 8134 New Lagrange Road Suite 100, Louisville, KY 40222 | 2020-11-06 |
| 1700424157 | Hope4hearts Counseling LLC | Community/Behavioral Health | 7321 New Lagrange Road, Louisville, KY 40222 | 2019-12-17 |
| 1982162509 | Sydney Sleadd | Massage Therapist | 7505 New Lagrange Rd, Ste 101, Louisville, KY 40222 | 2019-03-04 |
| 1205390127 | Rebecca A Street | Marriage & Family Therapist | 8134 New La Grange Rd Ste 227, Louisville, KY 40222 | 2019-01-24 |
| 1689176166 | Andrew Pennington | Social Worker | 1015 Dorsey Ln., Louisville, KY 40222 | 2018-03-01 |
| 1578085957 | Megan Lusco | Case Manager/Care Coordinator | 312 Whittington Parkway, Suite 020, Louisville, KY 40222 | 2017-07-07 |
| 1083149868 | Kate Oliver Ray | Optometrist | 2420 Lime Kiln Ln Ste H, Louisville, KY 40222 | 2017-04-28 |
| 1578094736 | Jacqueline Ward | Speech-Language Pathologist | 910 Fenley Avenue, Louisville, KY 40222 | 2017-03-21 |
| 1295195907 | Carol Massey | Psychologist | 7400 Newlagrange Roed, 308, Louisville, KY 40222 | 2016-02-24 |
| 1588047260 | Melissa Cosby | Case Manager/Care Coordinator | 312 Whittington Parkway Suite 020, Louisville, KY 40222 | 2015-06-30 |
| Find all providers in zip 40222 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437393170 | Bradley Scott Folley | Clinical Neuropsychologist | 4950 Norton Healthcare Blvd Ste 205, Louisville, KY 40241-2847 | 2009-04-24 |
| 1265689475 | Marilyn M. Wagner Ph.d., Psc | Clinical Neuropsychologist | 105a Crescent Ave, Louisville, KY 40206-1525 | 2008-08-20 |
| 1073704011 | Jennifer A Geiger | Clinical Neuropsychologist | 275 Century Cir Ste 203, Louisville, CO 80027-9453 | 2007-08-06 |
| 1619186467 | James Frederick Phifer | Clinical Neuropsychologist | 440 Breckenridge Lane Ste 124, Louisville, KY 40218 | 2007-05-21 |
| 1508916958 | Michael H Cecil | Clinical Neuropsychologist | 13293 Obannon Station Way, Louisville, KY 40223-4188 | 2007-01-10 |
| 1154301356 | Donald Bradley Burton | Clinical Neuropsychologist | 4200 Browns Ln, Louisville, KY 40220-1523 | 2006-01-23 |
| 1356333090 | Melissa A Boyles | Clinical Neuropsychologist | 2915 Frankfort Ave, Suite E, Louisville, KY 40206-2682 | 2005-08-18 |
| 1518968205 | Richard I Edelson | Clinical Neuropsychologist | 7511 New Lagrange Rd, Louisville, KY 40222-4859 | 2005-08-03 |
| 1164429320 | Jeanne Marie Bennett | Clinical Neuropsychologist | 1169 Eastern Pkwy Ste 2238, Louisville, KY 40217-1444 | 2005-07-02 |
| 1174520530 | Dennis Buchholz | Clinical Neuropsychologist | 1161 E Broadway, Louisville, KY 40204-1711 | 2005-06-30 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40222 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.