Provider Demographics
NPI:1447222997
Name:GRABER, CONNIE DENISE (PSYD)
Entity type:Individual
Prefix:
First Name:CONNIE
Middle Name:DENISE
Last Name:GRABER
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 N SCOTTSDALE RD STE 2500
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-7630
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:900 DOUGLAS PIKE STE 220
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02917-1879
Practice Address - Country:US
Practice Address - Phone:401-785-0040
Practice Address - Fax:401-941-7847
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD396103TC0700X
RIPS02334103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN40M62SWOtherCC SYSTEMS/ BLUE PLUS
MN92411422904OtherPRIMEWEST
SDP396OtherDAKOTACARE
SD0008183OtherBLUE CROSS
SD1402466OtherARAZ/ AMERICA'S PPO
SD231488OtherMIDLANDS CHOICE
SD25924OtherSANFORD HEALTH PLAN
SD769191028797OtherPREFERRED ONE
SDHP35188OtherHEALTHPARTNERS
SD6551770Medicaid
SD57108D007OtherWPS TRICARE
SD680014064OtherRR MEDICARE
MN151769OtherUCARE
IA3148379Medicaid
MN744420600Medicaid
SD0008183OtherBLUE CROSS
MN92411422904OtherPRIMEWEST
MN40M62SWOtherCC SYSTEMS/ BLUE PLUS
SDS8183Medicare PIN