Active NPI
Kysa Christie, PHD
- Clinical Psychologist
- West Roxbury, MA
National Provider Identifier
1780920223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 25642
- Practice address
- 1400 VFW Parkway (Sci 128)
West Roxbury, MA 02132 - Phone
- (617) 323-7700
- NPI assigned
- Jan 2, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 25642 | CA | Primary |
Addresses
Primary practice location
1400 VFW Parkway (Sci 128)
West Roxbury, MA 02132
Mailing address
1400 VFW Parkway (Sci 128)
West Roxbury, MA 02132
Phone (617) 323-7700
Medicare participation
Medicare enrollment files- 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
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25642 | CA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1357084800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1436832000000",
"number": "1780920223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 VFW PARKWAY (SCI 128)",
"city": "WEST ROXBURY",
"state": "MA",
"postal_code": "02132",
"telephone_number": "617-323-7700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 VFW PARKWAY (SCI 128)",
"city": "WEST ROXBURY",
"state": "MA",
"postal_code": "02132",
"telephone_number": "617-323-7700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHRISTIE",
"first_name": "KYSA",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-02",
"last_updated": "2015-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "25642",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Roxbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 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.