Active NPI
Christine Ann Gidycz, PH.D.
- Clinical Psychologist
- Athens, OH
National Provider Identifier
1922538248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 4228
- Practice address
- Ohio University
002 Porter Hall
Athens, OH 45701 - Phone
- (740) 593-0902
- NPI assigned
- Jun 19, 2017
- Last updated
- Jun 19, 2017
- 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 | 4228 | OH | Primary |
Addresses
Primary practice location
Ohio University
002 Porter Hall
Athens, OH 45701
Mailing address
Ohio University
002 Porter Hall
Athens, OH 45701
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4228 | Other | OH | PSYCHOLOGY STATE LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4228 | OH | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1497830400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1497830400000",
"number": "1922538248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "OHIO UNIVERSITY",
"address_2": "002 PORTER HALL",
"city": "ATHENS",
"state": "OH",
"postal_code": "45701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "OHIO UNIVERSITY",
"address_2": "002 PORTER HALL",
"city": "ATHENS",
"state": "OH",
"postal_code": "45701",
"telephone_number": "740-593-0902"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIDYCZ",
"first_name": "CHRISTINE",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-06-19",
"last_updated": "2017-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OH",
"license": "4228",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOLOGY STATE LICENSE",
"identifier": "4228",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Athens, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.