Crystal Wildes, PSY.D., LP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY.0004027 Issued in CO

Practice address

4611 Plettner LN
Ste. 100
Evergreen, CO 80439-7396

Phone

(720) 443-3112

NPI assigned

Aug 17, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Insight Psychology, LLC

  • Community/Behavioral Health Agency
  • Evergreen, CO
  • NPI 1700321833
  NPD Authorized official
• Insight Psychology, LLC

  • Community/Behavioral Health Agency
  • Evergreen, CO
  • NPI 1962366880
  NPD Authorized official
• Community Reach Center, Inc

  • Community/Behavioral Health Agency
  • Thornton, CO
  • NPI 1316906886
  Medicare reassignment

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1003121898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 PLETTNER LN STE 100",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804397396",
            "telephone_number": "720-443-3112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 PLETTNER LN",
            "address_2": "STE. 100",
            "city": "EVERGREEN",
            "state": "CO",
            "postal_code": "804397396",
            "telephone_number": "720-443-3112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDES",
        "first_name": "CRYSTAL",
        "credential": "PSY.D., LP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-08-17",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "PSY.0004027",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9000154871",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua White, MPT
• Julie White
• Kenneth Francis White, D.D.S.
• Mary White, PT
• Randy D. Whitesell, PSY.D.
• Lanie Jean Wilkinson, MA, LPCC, RD
• Williams Orthodontics, PLLC
• Bryan Williams, D.D.S., M.S.D.
• Rose Marie Williams, MASSAGE THERAPIST
• Wilson Natural Healing Co.

• Clinical Psychologist in Evergreen, CO
• Providers in Evergreen, CO by specialty
• Clinical Psychologist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.