Active NPI
Kristyn Neckles, PSY.D
- Psychologist
- Athens, OH
National Provider Identifier
1689363483
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- P.07880
- Practice address
- 13 W Stimson Ave
Athens, OH 45701-2649 - Phone
- (740) 562-6948
- NPI assigned
- May 5, 2023
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | P.07880 | OH | Primary |
Addresses
Primary practice location
13 W Stimson Ave
Athens, OH 45701-2649
Mailing address
13 Westfield PL
Athens, OH 45701-3853
Phone (786) 602-2810
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P.07880 | OH | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1683244800000",
"number": "1689363483",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13 WESTFIELD PL",
"city": "ATHENS",
"state": "OH",
"postal_code": "457013853",
"telephone_number": "786-602-2810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13 W STIMSON AVE",
"city": "ATHENS",
"state": "OH",
"postal_code": "457012649",
"telephone_number": "740-562-6948"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NECKLES",
"first_name": "KRISTYN",
"credential": "PSY.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-05",
"last_updated": "2023-05-05",
"certification_date": "2023-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychologist",
"state": "OH",
"license": "P.07880",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Athens, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.