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).
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 |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TH0100X |
Psychologist Specialization: Health Service |
Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
OK | 100838100A | 05 | |
OK | 100839060A | 05 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | GRUNDY PSYCHOLOGICAL SERVICES, P.C. | 205 Ketchum Avenue, Ketchum, OK 74349 |
Street Address |
205 KETCHUM AVENUE |
City | KETCHUM |
State | OK |
Zip Code | 74349 |
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 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1639779606 | Rooted Womens Health | Occupational Therapist | 431 N Walnut Ave, Ketchum, ID 83340 | 2020-10-29 |
1841826252 | Pilar Settlemier Tumolo | Counselor | 220 River Street East, Ketchum, ID 83340 | 2020-03-17 |
1598390643 | Alyson Holmes Witmer | Counselor | 220 2nd Ave, Ste 201, Ketchum, ID 83340 | 2020-03-10 |
1952864506 | Mollie Parker Szybala | Naturopath | 128 Saddle Rd, Suite 103-c, Ketchum, ID 83340 | 2019-04-10 |
1740789353 | Courtney Loving | Counselor | 208 N. Spruce, Ketchum, ID 83340 | 2018-02-09 |
1164876785 | Rebecca Grace | Psychologist | 200 River St East, Ketchum, ID 83340 | 2016-04-20 |
1306209556 | Garrett Coman | Dermatology | St. Luke's Dermatology, 191 5th Street West, Ketchum, ID 83340 | 2016-04-04 |
1265895775 | Innerhealth Md PC | Acupuncturist | 180 West 1st Street, Suite 206, Ketchum, ID 83340 | 2016-04-01 |
1487023503 | Tomomi Ikawa | Chiropractor | 131 4th St. E., Suite 310, Ketchum, ID 83340 | 2015-09-18 |
1538576020 | Joel Jarolimek Dc Inc. | Chiropractor | 660 2nd Ave. N, 1b, Ketchum, ID 83340-8044 | 2014-07-16 |
Find all providers in KETCHUM |
Taxonomy Code | 103TH0100X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Health Service |
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] |
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 |
Find all providers with the same taxonomy |
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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.