Individual provider Active NPI

Christyn Jayne Carriker, L.M.H.C.

  • Mental Health Counselor
  • Worcester, MA
National Provider Identifier
1386841112
Registry record updated Sep 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
4663 Issued in MA
Practice address
585 Lincoln St
Worcester, MA 01605-1906
Phone
(508) 831-0045
Fax
(508) 753-5051
NPI assigned
Jun 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 4663 MA Primary

Addresses

Primary practice location

585 Lincoln St
Worcester, MA 01605-1906

Mailing address

585 Lincoln St
Worcester, MA 01605-1906
Phone (508) 831-0045

Other identifiers 2

IdentifierTypeStateIssuer
1308785, 1306421MedicaidMA
M18684OtherMABCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 30, 2024 through Dec 30, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4663MAMDFamily Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Systems, Inc Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221436800000",
    "number": "1386841112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 LINCOLN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016051906",
            "telephone_number": "508-831-0045",
            "fax_number": "508-753-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 LINCOLN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016051906",
            "telephone_number": "508-831-0045",
            "fax_number": "508-753-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRIKER",
        "first_name": "CHRISTYN",
        "middle_name": "JAYNE",
        "name_prefix": "Ms.",
        "credential": "L.M.H.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2008-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "4663",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1308785, 1306421",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M18684",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.