NPIMap

Organization Active NPI

Child & Family Psychological Services, Inc.

  • Clinical Child & Adolescent Psychologist
  • Worthington, OH
National Provider Identifier
1700936937
Registry record updated May 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
3860 Issued in OH
Legal business name
CHILD & FAMILY PSYCHOLOGICAL SERVICES, INC.
Practice address
25 Kenyon Brook Dr
Worthington, OH 43085-3629
Phone
(614) 537-2604
NPI assigned
Jan 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Mary A Fristad, PHD
Title
President
Phone
(614) 537-2604

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC2200X 3860 OH Primary

Addresses

Primary practice location

25 Kenyon Brook Dr
Worthington, OH 43085-3629

Mailing address

25 Kenyon Brook Dr
Worthington, OH 43085-3629
Phone (614) 537-2604

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336608000000",
    "number": "1700936937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 KENYON BROOK DR",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430853629",
            "telephone_number": "614-537-2604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 KENYON BROOK DR",
            "city": "WORTHINGTON",
            "state": "OH",
            "postal_code": "430853629",
            "telephone_number": "614-537-2604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD & FAMILY PSYCHOLOGICAL SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2012-05-10",
        "status": "A",
        "authorized_official_last_name": "FRISTAD",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "614-537-2604",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "OH",
            "license": "3860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worthington, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.