Christopher Kyle Owen

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

6352000733 Issued in MI

Practice address

3005 Boardwalk St Ste 201
Ann Arbor, MI 48108-5218

Phone

(734) 222-9277

NPI assigned

Sep 22, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 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": "1663804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1235852468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3164 ANN ARBOR SALINE RD APT 204",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481039858",
            "telephone_number": "484-356-8535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3005 BOARDWALK ST STE 201",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481085218",
            "telephone_number": "734-222-9277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWEN",
        "first_name": "CHRISTOPHER",
        "middle_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-22",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6352000733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DOCTORAL TEMPORARY EDUCATIONAL LIMITED LICENSE - PSYCHOLOGIST (TLLP)",
            "identifier": "6352000733",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.therapynotes.com",
            "affiliation": "N",
            "endpointDescription": "EMR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3005 Boardwalk St Ste 201",
            "city": "Ann Arbor",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481085218",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christina Ann Overgaard, PTA
• Richard Elliott Overman, M.D.
• Marilyn Overmyer, MSW
• Rieham Owda, MD
• David Wellington Owen-Cruise, LLP
• Debra Owen
• Susan Valerie Owen, MA, RN
• Cameron B Owens
• Gabe Eston Owens, MD, PHD
• Kristen Michelle Owens, P.A.

• Clinical Child & Adolescent Psychologist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinical Child & Adolescent Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.