DR. GRACE MACDOWELL (NPI# 1649567728) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1649567728 |
Entity Type | Individual |
Full Name | DR. GRACE MACDOWELL |
Other Name | DR. GRACE MACDOWELL |
Credential | PSY.D. |
Practice Address |
11762 S State St Ste 160 Draper UT 84020-7174 |
Mailing Address |
1635 Ohio St Watertown NY 13601-3032 |
Practice Telephone | 8016543229 |
Practice Fax Number | 8016011408 |
Mailing Telephone | 3156814112 |
Mailing Fax Number | 3152822888 |
Enumeration Date | 2011-07-08 |
Last Update Date | 2020-11-05 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103G00000X | Clinical Neuropsychologist | 9469748-2501 | UT | Behavioral Health & Social Service Providers |
N | 103G00000X | Clinical Neuropsychologist | 019217 | NY | Behavioral Health & Social Service Providers |
N | 103TC0700X |
Psychologist Specialization: Clinical |
019217 | NY | Behavioral Health & Social Service Providers |
N | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
9469748-2501 | UT | Behavioral Health & Social Service Providers |
N | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
946748-2501 | UT | Behavioral Health & Social Service Providers |
N | 103TM1800X |
Psychologist Specialization: Mental Retardation & Developmental Disabilities |
019217 | NY | Behavioral Health & Social Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NY | MEDICARE PTAN | J300059371 | 01 |
Street Address |
11762 S STATE ST STE 160 |
City | DRAPER |
State | UT |
Zip Code | 84020-7174 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992321137 | Mariana Nibley | Nurse Practitioner | 11762 S State St Ste 160, Draper, UT 84020-7174 | 2020-06-23 |
1992324206 | Anew Clinical Practitioners Pllc | Nurse Practitioner | 11762 S State St Ste 160, Draper, UT 84020-7174 | 2020-04-16 |
1144853615 | Glade Woolstenhulme | Social Worker | 11762 S State St Ste 160, Draper, UT 84020-7158 | 2020-02-12 |
1689145963 | Anew Clinical Practitioners Pllc | Nurse Practitioner | 11762 S State St Ste 160, Draper, UT 84020-7174 | 2018-12-11 |
1942662655 | Tasia Roth | Social Worker | 11762 S State St Ste 160, Draper, UT 84020-7174 | 2016-03-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1194322776 | Chase Larsen Dmd Pllc | Dentist | 723 E 12200 S, Draper, UT 84020 | 2020-10-06 |
1780222380 | Derek Cragun | Counselor | 11706 700 E, Draper, UT 84020 | 2019-12-13 |
1720629371 | Own My Health Medical | Clinic/Center | 12371 900 E, Suite 102, Draper, UT 84020 | 2019-10-04 |
1508418856 | Thomas Mifflin | Physician Assistant | 721 East 12200 South, Draper, UT 84020 | 2019-07-16 |
1124670872 | Necia Dalley | Registered Nurse | 11800 S State St, Draper, UT 84020 | 2019-07-12 |
1285100784 | Tracey M Williams | Psychologist | 13200 S 1601 E, Draper, UT 84020 | 2018-10-23 |
1275008328 | Amoni Paeahelotu Finau | Community Health Worker | 13703 Wheatfield Way, Draper, UT 84020 | 2018-10-04 |
1891275525 | Cynthia Mae Bolton | Psychologist | 1192 E Draper Parkway # 447, Draper, UT 84020 | 2018-08-21 |
1164908026 | Headin' Home Inc. | Community/Behavioral Health | 12300 S. 150 W., Draper, UT 84020 | 2018-07-13 |
1366932576 | Forest Hulet | Dentist | 219 E 12300, Ste I-5, Draper, UT 84020 | 2018-05-14 |
Find all providers in zip 84020 |
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 |
---|---|---|---|---|
1780215269 | Reboot Centers Hobble Creek | Clinical Neuropsychologist | 1154 Left Fork Hobble Creek Canyon Rd, Springville, UT 84663 | 2020-02-03 |
1497254304 | Ctr Supports | Clinical Neuropsychologist | 10182 S Campden Ct, South Jordan, UT 84009-7109 | 2018-02-06 |
1770954356 | Erin Elizabeth Krauskopf | Clinical Neuropsychologist | 231 E 400 S Ste 335, Salt Lake City, UT 84111-2806 | 2015-10-08 |
1528469947 | Jordan Harris Rigby | Clinical Neuropsychologist | 230 S 500 E Ste 100, Salt Lake City, UT 84102-2048 | 2014-09-05 |
1366719601 | Joann T. Tschanz | Clinical Neuropsychologist | 2810 Old Main Hill, Utah State University, Logan, UT 84322-2810 | 2011-11-30 |
1215239348 | Jon Leroy Pertab | Clinical Neuropsychologist | 5171 South Cottonwood St Suite 810, Neurosciences Institute, Murray, UT 84107 | 2010-11-22 |
1619287208 | Lisa Michelle Sugerman | Clinical Neuropsychologist | 389 W 10000 S Ste A, South Jordan, UT 84095-4104 | 2010-10-15 |
1154565729 | Keith Mcgoldrick | Clinical Neuropsychologist | 1733 S 1100 E Ste 102, Salt Lake City, UT 84105-3482 | 2009-04-27 |
1356593297 | Dustin Bradshaw Hammers | Clinical Neuropsychologist | 650 Komas Dr Ste 106a, Salt Lake City, UT 84108-1225 | 2008-10-22 |
1730301474 | Beverly O'connor | Clinical Neuropsychologist | 533 26th St, Suite 100, Ogden, UT 84401-2465 | 2007-05-03 |
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.