Active NPI
Christine McKibbin, PH.D.
- Clinical Psychologist
- Laramie, WY
National Provider Identifier
1508283946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 493
- Practice address
- 2524 Dover Dr
Laramie, WY 82072-2990 - Phone
- (858) 229-7779
- NPI assigned
- Mar 24, 2014
- Last updated
- Mar 24, 2014
- Sex
- Female
- Sole proprietor
- Yes
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 | 493 | WY | Primary |
Addresses
Primary practice location
2524 Dover Dr
Laramie, WY 82072-2990
Mailing address
2524 Dover Dr
Laramie, WY 82072-2990
Phone (858) 229-7779
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 |
|---|---|---|---|
| 493 | WY | MD | Orthopedic Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1395619200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395619200000",
"number": "1508283946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2524 DOVER DR",
"city": "LARAMIE",
"state": "WY",
"postal_code": "820722990",
"telephone_number": "858-229-7779"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2524 DOVER DR",
"city": "LARAMIE",
"state": "WY",
"postal_code": "820722990",
"telephone_number": "858-229-7779"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKIBBIN",
"first_name": "CHRISTINE",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-03-24",
"last_updated": "2014-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WY",
"license": "493",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laramie, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.