Individual provider Active NPI

Christy R. Crick, MA, LMFT

  • Marriage & Family Therapist
  • Bristol, TN
National Provider Identifier
1063071926
Registry record updated Jul 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
1594 Issued in TN
Practice address
26 Midway St
Bristol, TN 37620-1706
Phone
(423) 989-4500
Fax
(423) 989-4582
NPI assigned
Jun 13, 2019
Last updated
Jul 5, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 1594 TN Primary

Addresses

Primary practice location

26 Midway St
Bristol, TN 37620-1706

Mailing address

1167 Spratlin Park Dr
Gray, TN 37615-6205
Phone (423) 467-3600

Other practice location 1

109 W Watauga Ave
Johnson City, TN 37604-5621
Phone (423) 232-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20231215003051 TN Practitioner - Marriage and Family Therapist 8729437710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Frontier HealthGroup PAC ID 2860302320, 70 clinicians

Practice addresses (Care Compare)

26 Midway St
Bristol, TN 37620-1706
Phone (423) 467-3600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
1594TNMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Frontier Health CurrentSince Jan 1, 2024 Accepting new patients
Frontier Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

1145 Volunteer Pkwy
Bristol, TN 37620
Phone (423) 989-4500

26 Midway St
Bristol, TN 37620
Phone (423) 989-4500

109 W Watauga Ave
Johnson City, TN 37604
Phone (423) 232-2600

1167 Spratlin Park Dr
Johnson City, TN 37615
Phone (423) 232-2670

318 Donnelly St
Mountain City, TN 37683
Phone (423) 727-2100

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688515200000",
    "number": "1063071926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1167 SPRATLIN PARK DR",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376156205",
            "telephone_number": "423-467-3600",
            "fax_number": "423-467-3644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 MIDWAY ST",
            "city": "BRISTOL",
            "state": "TN",
            "postal_code": "376201706",
            "telephone_number": "423-989-4500",
            "fax_number": "423-989-4582"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "109 W Watauga Ave",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376045621",
            "country_code": "US",
            "telephone_number": "423-232-2600",
            "fax_number": "423-232-2646",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CRICK",
        "first_name": "CHRISTY",
        "middle_name": "R.",
        "credential": "MA, LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-13",
        "last_updated": "2023-07-05",
        "certification_date": "2023-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TN",
            "license": "1594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bristol, TN

Sources for this page

Verify at the official NPI Registry.