Active NPI
Christine Lynne Chukabarah, PH.D.
- Clinical Psychologist
- Robins Afb, GA
National Provider Identifier
1427023027
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- AL1008
- Practice address
- 100 Page Rd
Suite D160, Wralc/DPH
Robins Afb, GA 31098-1600 - Phone
- (478) 327-7680
- Fax
- (478) 327-7685
- NPI assigned
- Feb 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | AL1008 | AL | Primary |
Addresses
Primary practice location
100 Page Rd
Suite D160, Wralc/DPH
Robins Afb, GA 31098-1600
Mailing address
106 Sasser Dr
Bonaire, GA 31005-4138
Phone (478) 918-3486
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL1008 | AL | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140134400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184544000000",
"number": "1427023027",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 SASSER DR",
"city": "BONAIRE",
"state": "GA",
"postal_code": "310054138",
"telephone_number": "478-918-3486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 PAGE RD",
"address_2": "SUITE D160, WRALC/DPH",
"city": "ROBINS AFB",
"state": "GA",
"postal_code": "310981600",
"telephone_number": "478-327-7680",
"fax_number": "478-327-7685"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUKABARAH",
"first_name": "CHRISTINE",
"middle_name": "LYNNE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-02-17",
"last_updated": "2007-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "AL",
"license": "AL1008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Robins Afb, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.