Michele Marie Crist, PH.D.

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

2583 Issued in OH

Practice address

5450 Far Hills Ave
Kettering, OH 45429-2386

Phone

(937) 554-7156

NPI assigned

Aug 31, 2006

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 identifiers 1

Other names 1

• Dr. Michele Marie Henry Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238025600000",
    "number": "1427160027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 FAR HILLS AVE",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454292386",
            "telephone_number": "937-554-7156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 FAR HILLS AVE",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454292386",
            "telephone_number": "937-554-7156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRIST",
        "first_name": "MICHELE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "OH",
            "license": "2583",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0334785",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "HENRY",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William Edward Coyne, DDS
• Barbara Lynn Crabill, MS/LPCC-S
• Cheri M. Cramer
• Joel Andrew Crane, DO
• Brian Crawford
• Casey Critchell
• Lisa Cron
• Nolan Cron
• Shawn M Crone, LMT
• James Gilbert Cross, PA-C

• Clinical Child & Adolescent Psychologist in Kettering, OH
• Providers in Kettering, OH by specialty
• Clinical Child & Adolescent Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2009; 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.