GRUNDY PSYCHOLOGICAL SERVICES, P.C.


Address: 205 Ketchum Avenue, Ketchum, OK 74349
Phone: 9186298664

GRUNDY PSYCHOLOGICAL SERVICES, P.C. (NPI# 1457827016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1457827016
Entity Type Organization
Organization Name GRUNDY PSYCHOLOGICAL SERVICES, P.C.
Practice Address 205 Ketchum Avenue
Ketchum
OK 74349
Mailing Address Po Box 6
Ketchum
OK 74349-0006
Practice Telephone 9186298664
Practice Fax Number 9187824301
Mailing Telephone 9186298664
Mailing Fax Number 9187824301
Enumeration Date 2018-10-22
Last Update Date 2018-10-22
Authorized Official Name DR. ELIZABETH MOLLETTE GRUNDY (VICE PRESIDENT)
Authorized Official Telephone 9188558315
Authorized Official Credential PH.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 103TH0100X Psychologist
Specialization: Health Service
Behavioral Health & Social Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
OK 100838100A 05
OK 100839060A 05

Other Data Sources

Entity Type Entity Name Entity Address
System for Award Management (SAM) Entities GRUNDY PSYCHOLOGICAL SERVICES, P.C. 205 Ketchum Avenue, Ketchum, OK 74349

Office Location

Street Address 205 KETCHUM AVENUE
City KETCHUM
State OK
Zip Code 74349

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1225421456 Tricia Willyard Speech-Language Pathologist 404 North Boston, Ketchum, OK 74349 2015-03-12
1811998164 Country Style Health Care Inc Home Health 156 South El Paso Y, Ketchum, OK 74349-0299 2005-08-09
1952470981 Ketchum Public School Local Education Agency (LEA) 404 North Boston, Ketchum, OK 74349-0720 2006-11-06

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1487023503 Tomomi Ikawa Chiropractor 131 4th St. E., Suite 310, Ketchum, ID 83340 2015-09-18
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Taxonomy Information

Taxonomy Code 103TH0100X
Grouping Behavioral Health & Social Service Providers
Classification Psychologist
Specialization Health Service

Taxonomy Definition

A psychologist, certified/licensed at the independent practice level in his/her state, who is duly trained and experienced in the delivery of direct, preventative, assessment, and therapeutic intervention services to individuals whose growth, adjustment, or functioning is actually impaired or is demonstrably at high risk of impairment (1974).
Notes: Source: National Register of Health Service Providers in Psychology website http://www.nationalregister.org/about_NR.html [7/1/2006: modified title, added definition]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1891212551 Mary Elizabeth Mohon Psychologist Oklahoma Vamc 921 Ne 13th Street, 11g, Oklahoma City, OK 73104 2017-08-24
1255855110 Christopher Thomas Copeland Psychologist 920 Stanton L Young Blvd # Wp3445, Oklahoma City, OK 73104-5036 2017-08-01
1588063085 La'queion Ballard Psychologist 2221 Ne 24th St, Oklahoma City, OK 73111-3421 2014-08-20
1346660412 Mental Wellness Services, LLC Psychologist 3605 Nw 175th St, Edmond, OK 73012-6901 2014-04-16
1285915710 Gloria P Okelley Psychologist 4400 Hemingway Dr., # 221, Oklahoma City, OK 73118 2011-08-29
1023214392 Robert J. Powitzky Psychologist 4710 Hemlock Cir, Oklahoma City, OK 73162-1938 2007-06-25
1407070790 Ralph Edmond Lindsey Psychologist 115 E 4th Ave, Stillwater, OK 74074-3527 2007-04-11
1497877765 Omar Wr Muhammad Psychologist 3312 E Maxwell Dr, Oklahoma City, OK 73121-2246 2007-04-05
1386787661 Lisa Myers Black Psychologist 4003 24th Ave Ne, Norman, OK 73071-7749 2007-02-15
1043393234 Curtis Todd Grundy Psychologist 1520 North Industrial Rd, Vinita, OK 74301 2006-10-23
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Competitor

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City KETCHUM
Zip Code 74349

Improve Information

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Dataset Information

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.

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