Dynesha Dione Mason-Grissom, PH.D.
NPI 1043789688ActiveIndividual· Psychologist· Champaign, IL
Psychologist (PH.D.) in Champaign, Illinois, with an NPI issued in November 2018. Enrolled in Medicare as practitioner - clinical psychologist.
Overview
| NPI | 1043789688 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PH.D. |
| Sole proprietor | No |
| NPI issued | Nov 13, 2018 |
| Last updated in NPPES | Jan 21, 2020 |
| Certified by provider | Jan 21, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Psychologist Primary | 103T00000X | — | — |
| Psychologist, Counseling | 103TC1900X | — | — |
| Psychologist, Clinical Child & Adolescent | 103TC2200X | — | — |
| Psychologist, Family | 103TF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Clinical Psychologist (IL) |
|---|
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