Kristin Mary Sheridan, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

6301005634 Issued in MI

Practice address

1191 River Oak Dr
Mount Pleasant, MI 48858-9301

Phone

(989) 773-6265

Fax

(989) 773-1409

NPI assigned

Nov 1, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Kristin M. Sheridan, PH.D., PC

  • Clinical Psychologist
  • Mt Pleasant, MI
  • NPI 1225227622
  NPD (past) Authorized official

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1351641600000",
    "number": "1497832752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1191 RIVER OAK DR",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488589301",
            "telephone_number": "989-773-6265",
            "fax_number": "989-773-1409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1191 RIVER OAK DR",
            "city": "MOUNT PLEASANT",
            "state": "MI",
            "postal_code": "488589301",
            "telephone_number": "989-773-6265",
            "fax_number": "989-773-1409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHERIDAN",
        "first_name": "KRISTIN",
        "middle_name": "MARY",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-01",
        "last_updated": "2012-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MI",
            "license": "6301005634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "680C745000",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashlee Danielle Shearer, MA, LLPC
• Rebecca Shebester
• Deborah Shelley
• Katherine Anne Shelton, LPN
• Mary Jo Beverly Shepard
• Tarami Kathryn Sherlock, LLPC
• Heril Unmeshkumar Sheth, RPT
• Brittney K Shinabarger
• Randall Shinaberry, MS OTRL
• Rene Revis Shingles, PH.D., ATC

• Psychologist in Mount Pleasant, MI
• Providers in Mount Pleasant, MI by specialty
• Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2012; 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.