Krystle Charon-Woods Hollier, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

6301016183 Issued in MI

Practice address

2888 W Grand Blvd
Detroit, MI 48202-2612

Phone

(313) 875-5017

NPI assigned

Jan 12, 2015

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 names 1

• Dr. Krystle Charon Woods Professional name

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Clinical Psychologist

Education

Michigan State University College of Human Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Downriver Mental Health Clinic PC

  • Psychologist
  • Taylor, MI
  • NPI 1295866135
  Medicare reassignment Care Compare group NPD
• Downriver Mental Health Clinic PC

  • Psychologist
  • Taylor, MI
  • NPI 1104930130
  NPD
• River'S Bend, P.C.

  • Addiction (Substance Use Disorder) Counselor
  • Troy, MI
  • NPI 1265520209
  NPD (past)

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

{
    "created_epoch": "1421020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645833600000",
    "number": "1316336506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 ARDEN PARK BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482021307",
            "telephone_number": "313-805-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2888 W GRAND BLVD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482022612",
            "telephone_number": "313-875-5017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLLIER",
        "first_name": "KRYSTLE",
        "middle_name": "CHARON-WOODS",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-12",
        "last_updated": "2022-02-26",
        "certification_date": "2022-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301016183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRYSTLE",
            "last_name": "WOODS",
            "middle_name": "CHARON",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Oshnique Holley, LPN
• Sheryl Holley
• Tiffani Holley
• Patrice Renae Holliday
• Yolanda Holliday, LPN, CMT, CCM, CNA
• Derrick Hollingsworth, MA
• Dorrian Hollingsworth, FNP
• Steven Hollingsworth
• Ervin Hollins Jr.
• Karla Lakriss Hollins, LMSW

• Clinical Psychologist in Detroit, MI
• Providers in Detroit, MI by specialty
• Clinical Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.