Jacqueline K Krychiw, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

60 Cuttermill Rd
Great Neck, NY 11021-3131

Phone

(516) 858-4328

NPI assigned

Sep 16, 2021

Sex

Female

Sole proprietor

No

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

Opted out of Medicare

Yes, effective Apr 7, 2023 through Apr 7, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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.

• Krychiw Psychological Services, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Huntington Station, NY
  • NPI 1598612046
  NPD Authorized official
• Cognitive Behavioral Associates, LLP

  • Cognitive & Behavioral Psychologist
  • Great Neck, NY
  • NPI 1184896417
  NPD (past)

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1609546167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "168 FULTON ST APT 205",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117352565",
            "telephone_number": "908-427-1226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 CUTTERMILL RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110213131",
            "telephone_number": "516-858-4328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KRYCHIW",
        "first_name": "JACQUELINE",
        "middle_name": "K",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-16",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eileen Krim, M.D.
• Kambhampaty Krishnasastry, MD
• Valeria Krivelevich, MA, CCC-SLP
• Stacey Jill Kruger, M.D.
• Jonathan Krup, D.P.T.
• Jay Kugler, M.D.
• Roger W Kula, MD, FAAN
• Savannah Kumar
• Rushil Kumbhani, MD
• Nicholas Michael Kunda, M.D.

• Psychologist in Great Neck, NY
• Providers in Great Neck, NY by specialty
• Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.