Affiliated Sante Group Dba Crisys
Organization Active NPI Cognitive & Behavioral Psychologist · Charlotee, NC
NPI 1700929940 · NPPES record last updated Jan 11, 2023
Key facts
- NPI
- 1700929940
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Cognitive & Behavioral Psychologist 103TB0200X
- Legal business name
- AFFILIATED SANTE GROUP DBA CRISYS
- Practice address
- 810 Tyvola Rd. Ste. 126
Charlotee, NC 28217-3536 - Phone
- (704) 566-3410
- Fax
- (301) 572-5062
- NPI assigned
- Feb 15, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Michelle Grigsby-Hackett, LCPC, CPRP
- Title
- Ceo
- Phone
- (301) 572-6358
Practitioners 1
-
Tracy Elaine Hickman, CRC, LPC, LCAS
National Provider Directory
Locations
5820 E Wt Harris Blvd
Ste 211
Charlotte, NC 28215
Phone (704) 277-7031
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist |
103TB0200X | Yes |
Addresses
Primary practice location
810 Tyvola Rd. Ste. 126
Charlotee, NC 28217-3536
Mailing address
810 Tyvola Rd. Ste. 126
Charlotee, NC 28217-3536
Phone (704) 566-3410
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8301491 | Medicaid | NC |
Other names
- Crisys, LLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 11, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.