Christopher J Carlin, PSY.D.
Individual provider Active NPI Clinical Psychologist · Peculiar, MO
NPI 1740264241 · NPPES record last updated Jul 31, 2024
Key facts
- NPI
- 1740264241
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- 2001014377 (MO)
- Practice address
- 22901 S Ridgeview Dr
Peculiar, MO 64078-0195 - Phone
- (417) 321-4881
- Fax
- (866) 223-4072
- NPI assigned
- Nov 30, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
22901 S Ridgeview Dr
Peculiar, MO 64078-0195
Phone (417) 321-4881
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090416000532 | MO | Practitioner - Clinical Psychologist | 7113074766 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2001014377 | MO | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Psylin, Inc. | Clinical | Current |
Accepting new patients |
| Allied Mental Health Consultants LLC | Past |
Accepting new patients | |
| Allied Mental Health Associates, Inc. | Clinical | Past | Accepting new patients |
Locations
4049 Pennsylvania Ave
Ste 200
Kansas City, MO 64111
Phone (417) 321-4881
101 N Commercial St
Nevada, MO 64772
Phone (417) 321-4881
1210 W Ashland St
Nevada, MO 64772
Phone (417) 667-5064
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 2001014377 | MO | Yes |
Addresses
Primary practice location
22901 S Ridgeview Dr
Peculiar, MO 64078-0195
Mailing address
22901 S Ridgeview Dr
Peculiar, MO 64078-0195
Phone (417) 321-4881
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740264241 | Medicaid | MO | |
| 11461940 | Other | CAQH # | |
| MA3108001 | Other | MO | MEDICARE PTAN |
Other providers in Peculiar, MO
- Melissa S Birkett
- Heather Bloesser
- Jean Marie Bogusch
- Danet Lyn Bracken
- Amy M Briner
- Lauren Carver
- Jocelyn Mandy Chancery
- Tanner Christensen
- Colleen Clasen
- Anthony D Coleman
All providers in Peculiar, MO · Clinical Psychologist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.