DR. JACQUELYN J. GRAVEN (PSYD) – Clinical Neuropsychologist, NPI 1396763249

DR. JACQUELYN J. GRAVEN (PSYD) is a healthcare provider. based in Louisville, Kentucky. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PSYD. They hold a License No. 129389 (KY). The NPI Number for DR. JACQUELYN J. GRAVEN (PSYD) is 1396763249

Main info

Female
Sole Proprietor
22 Years Of Experience
Accepts Medicare Assignment
Name
DR. JACQUELYN J. GRAVEN (PSYD)
NPI
1396763249
Phone
(502) 690-8024
Address
421 BENJAMIN LANE
Enumeration Date
18 July 2006
Last Update Date
20 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5026908024
Graduation Year
2004 (22 years ago)
PAC ID
6002812054
Group Practice PAC ID
2567779713
Professional Enrollment ID
I20061013000362
Address ID
KY402223608LO8007XWAYX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

253 CLINICAL PSYCHOLOGIST in KY

Provider Addresses for DR. JACQUELYN J. GRAVEN (PSYD)

  • 421 BENJAMIN LANE

    STE 202

    LOUISVILLE, KY 40222

    Phone: (502) 690-8024

    Fax: (502) 690-8090

    Type: Mailing

  • 8007 LYNDON CIRCLE WAY

    STE 101

    LOUISVILLE, KY 40222

    Phone: (502) 690-8024

    Fax: (502) 690-8090

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-10-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20061013000362IClinical PsychologistKYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 40222)

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Provider's Procedures

DR. JACQUELYN J. GRAVEN (PSYD) performs procedures in CLINICAL PSYCHOLOGIST. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PSYCHOLOGIST, CLINICALKY96118Neuropsychological testing, interpretation, and report by psychologist or physician per hour6512

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2567779713View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. JACQUELYN J. GRAVEN (PSYD)?
DR. JACQUELYN J. GRAVEN (PSYD) — NPI 1396763249 — is the standard way to identify this listing.
Does the file indicate DR. JACQUELYN J. GRAVEN (PSYD) is practicing under active NPI?
Directory data currently reports DR. JACQUELYN J. GRAVEN (PSYD) as active.
What is DR. JACQUELYN J. GRAVEN (PSYD) best known for clinically?
Directory data describes DR. JACQUELYN J. GRAVEN (PSYD) with Clinical Neuropsychologist. Clinical services aligned with this taxonomy classification.
Where should I expect DR. JACQUELYN J. GRAVEN (PSYD) on a map?
Expect Louisville, Kentucky as a primary anchor for DR. JACQUELYN J. GRAVEN (PSYD) unless the record lists multiple sites.
Why does DR. JACQUELYN J. GRAVEN (PSYD) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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