Active NPI
Crystal Bowlby, PHD
- Clinical Psychologist
- Tulsa, OK
National Provider Identifier
1619210390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY23856
- Practice address
- 6655 S Yale Ave
Tulsa, OK 74136-3326 - Phone
- (918) 491-3700
- Fax
- (918) 481-4063
- NPI assigned
- Apr 1, 2013
- Last updated
- Dec 13, 2024
- 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 | PSY23856 | CA | Primary |
Addresses
Primary practice location
6655 S Yale Ave
Tulsa, OK 74136-3326
Mailing address
PO Box 707001
Tulsa, OK 74170-7001
Phone (918) 499-4855
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PSY23856 | Other | CA | PROFESSIONAL LICENSE |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY23856 | CA | MD | Clinical Psychologist |
| 1222 | OK | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Biola Counseling Center | Clinical | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Psychologist
- La Mirada, CA
- NPI 1255547378
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1364774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1734048000000",
"number": "1619210390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 707001",
"city": "TULSA",
"state": "OK",
"postal_code": "741707001",
"telephone_number": "918-499-4855",
"fax_number": "918-488-6098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6655 S YALE AVE",
"city": "TULSA",
"state": "OK",
"postal_code": "741363326",
"telephone_number": "918-491-3700",
"fax_number": "918-481-4063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWLBY",
"first_name": "CRYSTAL",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-04-01",
"last_updated": "2024-12-13",
"certification_date": "2024-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY23856",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROFESSIONAL LICENSE",
"identifier": "PSY23856",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Tulsa, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.