Dynesha Mason-Grissom, PH.D.
NPI 1043789688 · Psychologist · Champaign, IL
Enrolled with Medicare as Practitioner - Clinical Psychologist · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Dynesha Mason-Grissom, PH.D. is a Psychologist provider in Champaign, IL (NPI 1043789688).
Provider details
- NPI number
- 1043789688
- Entity type
- Individual
- Primary specialty
- PsychologistBehavioral Health & Social Service Providers
- Credential
- PH.D.
- Sex
- Female
- Sole proprietor
- No
Specialties & taxonomies
Behavioral Health & Social Service Providers
- Counseling Psychologist103TC1900X
Behavioral Health & Social Service Providers
- Clinical Child & Adolescent Psychologist103TC2200X
Behavioral Health & Social Service Providers
- Family Psychologist103TF0000X
Behavioral Health & Social Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
7 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2018-11-13
- Last updated
- 2020-01-21
- Certified
- 2020-01-21
Frequently asked questions
- What is Dynesha Mason-Grissom's NPI number?
- Dynesha Mason-Grissom's National Provider Identifier (NPI) is 1043789688, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Dynesha Mason-Grissom's specialty?
- Dynesha Mason-Grissom is listed in the NPPES registry with a primary specialty of Psychologist (Behavioral Health & Social Service Providers).
- Where is Dynesha Mason-Grissom located?
- Dynesha Mason-Grissom's practice location on file with NPPES is 2500 Galen Dr Ste 104, Champaign, IL 61821-7038.
- What is Dynesha Mason-Grissom's phone number?
- The practice phone number listed in the NPPES registry for Dynesha Mason-Grissom is (217) 693-6072.
- Does Dynesha Mason-Grissom accept Medicare?
- Dynesha Mason-Grissom is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Dynesha Mason-Grissom's NPI active?
- Yes — Dynesha Mason-Grissom's NPI (1043789688) is active in the NPPES registry as of the last update on 2020-01-21.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.