Michelle R Gryczkowski, PHD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

05840 Issued in MD

Practice address

7910 Woodmont Ave Ste 1101
Bethesda, MD 20814-7059

Phone

(301) 304-6116

NPI assigned

Oct 27, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 1, 2016 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Cognitive Behavior Therapy Center

  • Psychologist
  • Chesapeake, VA
  • NPI 1861075988
  NPD (past)

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

{
    "created_epoch": "1288137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724371200000",
    "number": "1073813804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7910 WOODMONT AVE STE 1101",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208147059",
            "telephone_number": "301-304-6116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7910 WOODMONT AVE STE 1101",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208147059",
            "telephone_number": "301-304-6116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRYCZKOWSKI",
        "first_name": "MICHELLE",
        "middle_name": "R",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-10-27",
        "last_updated": "2024-08-23",
        "certification_date": "2024-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "WI",
            "license": "3267",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "05840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Bethesda, MD
• Providers in Bethesda, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.