Individual provider Active NPI

Cristin Marie Saffo, PSY.D.

  • Psychologist
  • Youngsville, LA
National Provider Identifier
1790752517
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1646 Issued in LA
Practice address
100 Habersham Dr
Youngsville, LA 70592-5116
Phone
(336) 524-1628
Fax
(336) 792-5896
NPI assigned
Mar 1, 2006
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 7380 MA
Psychologist 103T00000X 4732 NC
Psychologist 103T00000X 1646 LA Primary

Addresses

Primary practice location

100 Habersham Dr
Youngsville, LA 70592-5116

Mailing address

4400 Ambassador Caffery Pkwy
Ste a #108
Lafayette, LA 70508-6760
Phone (336) 524-1628

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: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Oct 1, 2020 through Oct 1, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1646LAMDPsychologist
7380MAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pathways Psychology, LLC Psychologist CurrentSince Aug 11, 2024 Accepting new patients
Pathways Psychological Services, LLC Psychologist PastSince Jan 14, 2008 Accepting new patients
Walpole Physical Therapy Services, Inc PastSince Jul 21, 1999 Accepting new patients
Boston Healthcare Inc PastSince Jul 1, 2005 Accepting new patients

Locations

4400 Ambassador Caffery Pkwy
Ste A
Lafayette, LA 70508

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1141171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1790752517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 AMBASSADOR CAFFERY PKWY",
            "address_2": "STE A #108",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086760",
            "telephone_number": "336-524-1628",
            "fax_number": "336-792-5896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HABERSHAM DR",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705925116",
            "telephone_number": "336-524-1628",
            "fax_number": "336-792-5896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAFFO",
        "first_name": "CRISTIN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-01",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "7380",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "4732",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "LA",
            "license": "1646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Youngsville, LA

Sources for this page

Verify at the official NPI Registry.