Charles W Crook Psychologist Inc

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

CHARLES W CROOK PSYCHOLOGIST INC

Practice address

3400 Pacific Ave Apt 208
Marina del Rey, CA 90292-7815

Phone

(310) 428-8787

NPI assigned

Sep 20, 2021

Last updated

Sep 20, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Charles W Crook, PSYDNPI 1114485323

Title

President

Phone

(310) 428-8787

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Charles William Crook

  • Clinical Psychologist
  • Marina del Rey, CA
  • NPI 1114485323
  NPD Authorized official

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632096000000",
    "number": "1730859745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 PACIFIC AVE APT 208",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902927815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 PACIFIC AVE APT 208",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902927815",
            "telephone_number": "310-428-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES W CROOK PSYCHOLOGIST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-20",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A",
        "authorized_official_last_name": "CROOK",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-428-8787",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drchuck@painwisetherapy.com",
            "affiliation": "N",
            "address_1": "3400 Pacific Ave Apt 208",
            "city": "Marina Del Rey",
            "state": "CA",
            "country_code": "US",
            "postal_code": "902927815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Shawn N Chaikin, MD
• Phoebe Chakshuvej, FNP
• Wendy Chan, DPT, LAC, DIPL OM
• David Chang, M.D.
• Kevin Wesley Chang
• Jasmine Charles
• Arti H Chawla, M.D.
• Anna Koblik Chen, MD
• Leian Chen, MD
• Tina San Cheng, O.D.

• Clinical Psychologist in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2021; 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.