Chrystyna Michelle Head

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

23300 Greenfield Rd Ste 122
Oak Park, MI 48237-8408

Phone

(248) 968-9508

Fax

(248) 968-9516

NPI assigned

Jan 21, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1205426590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23300 GREENFIELD RD STE 122",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482378408",
            "telephone_number": "248-968-9508",
            "fax_number": "248-968-9516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23300 GREENFIELD RD STE 122",
            "city": "OAK PARK",
            "state": "MI",
            "postal_code": "482378408",
            "telephone_number": "248-968-9508",
            "fax_number": "248-968-9516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEAD",
        "first_name": "CHRYSTYNA",
        "middle_name": "MICHELLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-21",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801098969",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MI5839",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Oak Park, MI
• Providers in Oak Park, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.