Kristi Van Sickle, PSYD, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

License

PY7640 Issued in FL

Legal business name

KRISTI VAN SICKLE, PSYD, LLC

Practice address

163 5TH Ave NE
Saint Petersburg, FL 33701-3015

Phone

(727) 586-5192

NPI assigned

Apr 8, 2015

Organization subpart

No

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

Authorized official

Name

Kristi Sands Van Sickle, PSYDNPI 1427234533

Title

Owner/Psychologist

Phone

(727) 592-5186

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kristi Sands Van Sickle, PSY.D.

  • Psychologist
  • Saint Petersburg, FL
  • NPI 1427234533
  Medicare reassignment Authorized official
• Melissa D Fletcher, LMHC

  • Mental Health Counselor
  • Indialantic, FL
  • NPI 1851981930
  NPD (past)
• Jessica Termini, LMHC

  • Mental Health Counselor
  • Indialantic, FL
  • NPI 1225473085
  NPD (past)

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657670400000",
    "number": "1902292725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 5TH AVE NE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337013015",
            "telephone_number": "727-586-5192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 5TH AVE NE",
            "city": "SAINT PETERSBURG",
            "state": "FL",
            "postal_code": "337013015",
            "telephone_number": "727-586-5192"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "122 4th Ave",
            "address_2": "Suite 200",
            "address_purpose": "LOCATION",
            "city": "Indialantic",
            "state": "FL",
            "postal_code": "329033112",
            "country_code": "US",
            "telephone_number": "321-325-2235 x108",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KRISTI VAN SICKLE, PSYD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-08",
        "last_updated": "2022-07-13",
        "certification_date": "2022-07-13",
        "status": "A",
        "authorized_official_last_name": "VAN SICKLE",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_middle_name": "SANDS",
        "authorized_official_title_or_position": "OWNER/PSYCHOLOGIST",
        "authorized_official_telephone_number": "727-592-5186",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "FL",
            "license": "PY7640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Kristi@drkristivansickle.com",
            "affiliation": "N",
            "endpointDescription": "Business email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "PHI",
            "address_1": "163 5th Ave NE",
            "city": "Saint Petersburg",
            "state": "FL",
            "country_code": "US",
            "postal_code": "337013015",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jeffrey P Krill, OD
• Shawnon Marie Krimmel
• Sydney Krinkie, PA-C
• Donald J Krippendorf, D.C.
• Anthony Kriseman, M.D.
• Kristin Stallard
• Mark P. Krivoshik, MD
• Robert Kropp, M.D.
• Gerard E. Krueger, DDS,MS,FACP
• Gordon Elliott Krueger, DDS., MS

• Adult Mental Health Clinic/Center in Saint Petersburg, FL
• Providers in Saint Petersburg, FL by specialty
• Adult Mental Health Clinic/Center in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.