Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nickholas Grant, PHD

Individual provider Clinical Psychologist · NPI 1336967264

Nickholas Grant, PHD is a Clinical Psychologist in Orange, Connecticut. Qualified in 2020, 6 years ago. Practices with Northeast Neuropsychology LLC, a 17-clinician group and accepts Medicare assignment. Licensed in Connecticut.

Years since qualifying
6
Licensed in
CT
In the registry since
2024
What do these letters mean?
PHD — Doctor of Philosophy
A research doctorate. In healthcare it usually sits alongside a clinical licence.

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Practice location Address checks out

6222 Avalon Dr W
Orange, CT 06477-3684
Phone: (203) 701-6047
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Psychologist (primary) Taxonomy 103TC0700X · Licence 4836 (CT)

Record details

NPI number1336967264
Entity typeIndividual (Type 1)
GenderMale
Credentials PHD
Sole proprietorNo
NPI enumeratedSeptember 30, 2024
Last updated in NPPESSeptember 30, 2024
Certification dateSeptember 30, 2024
Mailing address2389 Main St Ste 100, Glastonbury, CT 06033-4617

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Northeast Neuropsychology Llc — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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