Michael Louis Carrizales, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

2966 Issued in OR

Practice address

2970 Kincaid St
Eugene, OR 97405-4158

Phone

(541) 636-1502

NPI assigned

Aug 27, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1566864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689811200000",
    "number": "1477101160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2852 WILLAMETTE ST # 355",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974058200",
            "telephone_number": "541-636-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2970 KINCAID ST",
            "city": "EUGENE",
            "state": "OR",
            "postal_code": "974054158",
            "telephone_number": "541-636-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRIZALES",
        "first_name": "MICHAEL",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-08-27",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OR",
            "license": "2966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alia Marie Carr
• Ashley L Carr, MA, QMHP
• Elizabeth Anne Carr, B.A.
• Thomas Kellen Carr, MH INTERN
• Maja Diane Carrel
• Barbara Carroll, CRNA
• Christina Elyce Carroll
• Kyra D. Carroll, CCC-SLP
• Mary Joanne Carroll
• Rebecca May Carroll, MD

• Clinical Psychologist in Eugene, OR
• Providers in Eugene, OR by specialty
• Clinical Psychologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.