Kristen J Aycock, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PSY003590 Issued in GA

Practice address

115 Habersham Dr
Fayetteville, GA 30214-7353

Phone

(770) 461-9944

NPI assigned

Aug 28, 2012

Sex

Female

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: 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 Jan 24, 2023 through Jan 24, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• A New Start Counseling Center Inc

  • Psychologist
  • Fayetteville, GA
  • NPI 1477619195
  NPD (past)
• Accordia Counseling Solutions

  • Counseling Psychologist
  • Fayetteville, GA
  • NPI 1518290857
  NPD (past)

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359590400000",
    "number": "1952659641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 HABERSHAM DR.",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30214",
            "telephone_number": "770-461-9944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 HABERSHAM DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147353",
            "telephone_number": "770-461-9944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AYCOCK",
        "first_name": "KRISTEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-28",
        "last_updated": "2013-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "PSY003590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Muhammad Aurangzeb, MD
• Traci Autera, DC
• Lisa M Avery, M.D.
• Stephen Otieno Awuor, M.D.
• David Wayne Aycock, PHD
• Timothy James Aycock, PHD
• Kristin Renee Ayers, DPT
• Babbling Bunch Speech Therapy LLC
• S. Bernard Bagley, LCSW
• Amanda Sullivan Bahler, APRN

• Psychologist in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Psychologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.