Kristin Lynn Mickel, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY9141 Issued in FL

Practice address

500 N Maitland Ave
Suite 110
Maitland, FL 32751-4482

Phone

(407) 628-5354

Fax

(407) 628-0254

NPI assigned

Sep 18, 2014

Last updated

Sep 18, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in FL

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.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2013

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

Villar Neuropsychology, LLCGroup PAC ID 8729396999, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Villar Neuropsychology, LLC

  • Clinical Neuropsychologist
  • Lake Mary, FL
  • NPI 1306239553
  Medicare reassignment Care Compare group NPD
• Maitland Psychology PA

  • Clinical Neuropsychologist
  • Maitland, FL
  • NPI 1871775445
  Medicare reassignment NPD
• Kristin P. Girardot, PH.D, LLC

  • Clinical Psychologist
  • Maitland, FL
  • NPI 1972807527
  NPD

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410998400000",
    "number": "1952703167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N MAITLAND AVE",
            "address_2": "SUITE 110",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514482",
            "telephone_number": "407-628-5354",
            "fax_number": "407-628-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N MAITLAND AVE",
            "address_2": "SUITE 110",
            "city": "MAITLAND",
            "state": "FL",
            "postal_code": "327514482",
            "telephone_number": "407-628-5354",
            "fax_number": "407-628-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICKEL",
        "first_name": "KRISTIN",
        "middle_name": "LYNN",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9141",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• MF Winter Park LLC (The Rehabilitation Center of Winter Park)
• Bahar Miah, M.D.
• Anne Mian, M.D.
• Michele H Bachmanllc
• Alana Renae Michener
• Danielle Mickla
• Mid Florida Infectious Diseases MD LLC
• Miguel Rodriguez-Gonzalez, M.D., P.a. (Cardiology Specialists of Central Florida)
• Rudy Mijares
• Sarah L Milam, LMHC, ATR

• Clinical Psychologist in Maitland, FL
• Providers in Maitland, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2014; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.