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DR. KENNETH JEROME GRAVES PH.D. NPI 1275689416


NPI Information

NPI: 1275689416
Provider Name: DR. KENNETH JEROME GRAVES, PH.D.
Classification: Psychologist - 103TC0700X
Entity Type: Individual

Specialization: Clinical

Address:
1005 W JEFFERSON BLVD
SUITE 205
DALLAS, TX
ZIP 75208
Phone: (214) 916-4025
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DR. Kenneth Jerome Graves, PH.D. is a clinical psychologist in Dallas, TX. The provider is a psychologist who provides continuing and comprehensive mental and behavioral health care for individuals and families; consultation to agencies and communities; training, education and supervision; and research-based practice. It is a specialty in breadth -- one that is broadly inclusive of severe psychopathology -- and marked by comprehensiveness and integration of knowledge and skill from a broad array of disciplines within and outside of psychology proper. The scope of clinical psychology encompasses all ages, multiple diversities and varied systems. DR. Kenneth Jerome Graves, PH.D. NPI is 1275689416. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1005 W JEFFERSON BLVD
SUITE 205
DALLAS, TX
ZIP 75208-087
Phone: (214) 916-4025

The enumeration date for this NPI number is 1/27/2007 and was last updated on 4/16/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103TC0700XPsychologistClinical30557TEXASYes
2103TC2200XPsychologistClinical Child & Adolescent30557TEXASNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10962334-01MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.