Jeffrey Alan Christiansen, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3785 Issued in OH

Practice address

172 Hudson Ave
Newark, OH 43055-5750

Phone

(740) 349-7793

Fax

(740) 349-7792

NPI assigned

Apr 30, 2008

Last updated

Mar 13, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Boundless Health, Inc.

  • General Practice Dentistry
  • Worthington, OH
  • NPI 1710575360
  NPD (past)

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

{
    "created_epoch": "1209513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1750557716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172 HUDSON AVE",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430555750",
            "telephone_number": "740-349-7793",
            "fax_number": "740-349-7792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "172 HUDSON AVE",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430555750",
            "telephone_number": "740-349-7793",
            "fax_number": "740-349-7792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTIANSEN",
        "first_name": "JEFFREY",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-30",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "3785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Karl Choice, M.D.
• Jenna Chorpenning, LSW
• Amy Elizabeth Choulat
• Demira Christian
• William Christian
• Priscilla Leanne Christy, LSW
• CHS - Arlington, Inc (Arlington Care Center)
• Laura Church
• Yvonne Cicale, PTA
• Kristin Circle, MS, APRN, PMHNP-BC

• Clinical Psychologist in Newark, OH
• Providers in Newark, OH by specialty
• Clinical Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.